An RT in a hospital is a respiratory therapist, a licensed healthcare professional who specializes in helping patients breathe. If you or a family member is hospitalized, an RT is the person who manages ventilators, delivers breathing treatments, draws blood from arteries to check oxygen levels, and responds to life-threatening emergencies when someone stops breathing. They work alongside doctors and nurses but focus specifically on the lungs and cardiopulmonary system.
What a Respiratory Therapist Does
Respiratory therapists evaluate and treat patients with breathing problems or heart-lung disorders. Their day-to-day work in a hospital typically includes interviewing and examining patients, running diagnostic tests, administering treatments, and monitoring progress. They consult directly with physicians to develop treatment plans and adjust care as a patient’s condition changes.
One of the most common procedures RTs perform is an arterial blood gas (ABG) draw. This involves inserting a small needle into an artery, usually at the inner wrist, to collect a blood sample. The sample is then run through a blood gas analyzer to measure oxygen levels, carbon dioxide levels, and the blood’s pH balance. These numbers tell the care team whether a patient’s lungs are doing their job or whether treatment needs to change. If you’ve had blood drawn from your wrist rather than a vein in your arm, that was likely an RT.
RTs also perform lung function tests by having patients breathe into a device that measures how much air the lungs can hold and how quickly air moves in and out. They clear blocked airways using chest physiotherapy, a technique that involves rhythmic tapping on the chest to loosen mucus so the patient can cough it up. And they teach patients how to use inhalers, nebulizers, and other equipment both in the hospital and after discharge.
Equipment RTs Manage
Respiratory therapists are the primary operators of breathing equipment in a hospital. The most critical piece is the mechanical ventilator, the machine that breathes for patients who cannot do so on their own. RTs set up ventilators, calibrate the oxygen concentration and flow rate, and continuously monitor patients to make sure the settings are correct.
Beyond ventilators, RTs work with CPAP and BiPAP machines (devices that use air pressure to keep airways open, commonly used for sleep apnea but also for acute breathing problems), nebulizers that convert liquid medication into a fine mist patients inhale, incentive spirometers that encourage deep breathing after surgery, and portable oxygen delivery systems. In the most advanced cases, they may help manage technologies like extracorporeal membrane oxygenation (ECMO), which acts as an artificial lung by oxygenating blood outside the body.
RTs in Critical Care and Emergencies
Respiratory therapists play a central role in intensive care units, where many patients depend on ventilators or supplemental oxygen. They monitor breathing rates and oxygen saturation around the clock, adjusting equipment as conditions shift. In the ICU, RTs work closely with critical care physicians to manage some of the hospital’s sickest patients.
During a Code Blue, the hospital’s emergency response to cardiac arrest, the RT is part of the team that arrives at the bedside. Their specific job is to ventilate the patient using a resuscitation bag delivering 100% oxygen, prepare suction equipment, set up intubation supplies so a physician can place a breathing tube, assist during the intubation itself, and draw arterial blood gases to assess how the resuscitation is going. In these moments, the RT’s expertise in airway management is essential.
RTs in Neonatal Care
In the neonatal intensive care unit (NICU), respiratory therapists care for premature infants whose lungs haven’t fully developed. They use CPAP devices sized for newborns to help tiny patients breathe without a ventilator when possible, and manage mechanical ventilation when it’s necessary. One specialized task in the NICU is delivering surfactant, a substance that keeps the lungs’ air sacs from collapsing, directly into an infant’s lungs through a breathing tube.
NICU respiratory therapists also serve as a resource for parents, explaining what each piece of equipment does, teaching families to recognize signs of breathing distress, and providing emotional support during what is often a frightening time.
Conditions RTs Treat
Respiratory therapists treat patients across all age groups. The conditions they manage most frequently include asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumonia, and lung disease in elderly patients. They also care for trauma patients who need emergency airway support, post-surgical patients who need help re-expanding their lungs, and anyone on a ventilator regardless of the underlying diagnosis.
RTs can specialize in areas like neonatal or pediatric care, geriatric respiratory medicine, pulmonary rehabilitation, sleep studies (polysomnography), critical care, home care, and pulmonary diagnostics.
How RTs Differ From Nurses
Nurses provide broad patient care across many body systems. Respiratory therapists focus specifically on the lungs and cardiopulmonary function. While both professions monitor patients, record progress, and collaborate with physicians, RTs are the specialists when it comes to ventilator management, airway clearance, lung function testing, and arterial blood gas analysis. A nurse might notice a patient’s oxygen levels dropping, but the RT is typically the one called to assess the airway, adjust the ventilator, or deliver a targeted breathing treatment.
Education and Credentials
Becoming a respiratory therapist requires at minimum an associate degree from a program accredited by the Commission on Accreditation for Respiratory Care, though many RTs hold bachelor’s or master’s degrees. After graduation, candidates take a national exam called the Therapist Multiple-Choice Examination. Scoring above the lower threshold earns the Certified Respiratory Therapist (CRT) credential. Scoring above the higher threshold qualifies the candidate to sit for an additional Clinical Simulation Examination. Passing both exams earns the Registered Respiratory Therapist (RRT) credential, which many hospitals require for employment.
So when you see “RT” or “RRT” on a hospital badge, you’re looking at someone with specialized training in everything related to breathing, from routine inhaler education to keeping a critically ill patient alive on a ventilator.