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The History of Respiratory

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The management of medical condition through respiratory care/therapy has a very short but rich history. Respiratory care gives/therapists with other physicians and health professionals diagnose and treat patients with disorders in their respiratory and cardiovascular systems. Today, respiratory care has grown and become a dynamic and exciting profession in health care giving. Most top medical institutions offer respiratory care trainings. The demand for respiratory care givers has in the years been growing due to the efficacy of respiratory therapy in the management of myriad medical conditions and also the rise in the prevalence of respiratory medical conditions such as pneumonia and other respiratory diseases associated with diseases of the heart and other ailments that occur as a result of aging.   

The use of respiratory care/therapy in the management of medical conditions has had commendable results. This explains its growth and adoptions in the medical profession despite its short history. According to Egan, Wilkins, Stoller, & Kacmarek (2009) respiratory care was adopted in US in the early 1950s. During this period, medical professionals offering this care were called inhalation therapists. These individuals were charged with administering oxygen to patients in hospitals. However there are other indications that suggest that the history of respiratory care began much earlier than 1950s in the United States. Wyka Mathews & Clark (2001) provide that respiratory care giving began in the United States much earlier than 1940s as proved by the existence of oxygen administration equipments in hospitals before this period such as the oxygen tent argued to have been in use as early as 1926 and Nasal catheter said to have been in use by 1928. During this period, the main job of respiratory therapists included provision of oxygen to critically ill patients especially those in Intensive Care units (ICU).  Oxygen masks argued to have been developed in the early 1938 were mainly used by army pilots to aid in breathing.

It should be noted, there also very early indications that suggest that the use of respiratory care has been in use much earlier that has been indicated in the history of medicine. A very good example is the case Thomas Beddoes who is argued to be the first to use oxygen for therapeutic functions. He is also credited with the establishment of Pneumatic Institute of Bristol in England which is also known to be the first medical institution to have used oxygen for therapeutic reasons. According to Wyka Mathews & Clark (2001), Beddoes and his colleagues used primitive oxygen masks (made of oiled silk rags) to treat medical conditions such as heath diseases, asthma, leprosy, venereal diseases and opium addiction. Beddoes is referred to as the father of respiratory care despite the fact that oxygen did not have any therapeutic effect in any of the medical conditions that he was trying to cure.      

Today, the field has expanded and to include use of other gases in the management of medical conditions and operations. It also includes the monitoring and management of mechanical and computerized ventilators that have been designed to provide life support for patients undergoing operations through monitoring their respiratory systems and the heart and its hemodynamics.

The use of respiratory care in the management of medical conditions gained more recognition in the 1940s after a group of oxygen tank technicians in Illinois started meeting with doctors who were involved in the treatment of diseases related to the lungs. They formed a group in 1946 and named it Inhalation Therapy Association (ITA). This group focused on providing training for people involved in the administration of medical gases to patients. The first graduates for the trainings were awarded certificates in 1950 (Wyka Mathews & Clark 2001). These individuals however had little formal education but they had desire for practicing medicine. Egan, Wilkins, Stoller, & Kacmarek, (2009) provide that these were the primary group of people to receive formal certification in Inhalation therapy.

After the impact of the trainings provided by the ITA was witnessed, American College of Chest Physicians offered to provide sponsorship to ITA in 1953 which by now was holding annual conventions. By now they had attendants from 14 states and Canada. In 1954, the group elected a board of directors and changed its name from ITA to American Association of Inhalation Therapists (AAIT) with Sister Borromea as the president and Jimmy Young as the executive director. During this time, AAIT had started putting out monthly bulletin and also started forming state chapters (Wyka Mathews & Clark 2001). In 1957, American Society of Anaestologists (ASA) started to offer official sponsorship of AAIT which continued grow t a membership of around 600 members by 1958.

With advancement in technology, more technical and better equipment were introduced as well as other therapeutic techniques. By this time individuals practicing this type of medicine had the title “inhalation therapists”. Their main duty was to ensure that oxygen was properly used. They also administered intermittent positive pressure breathing (IPPB) treatments, performed CPR (cardiopulmonary resuscitation) and also operated negative pressure (iron lung) ventilators.

The growth of membership to AAIT was major revenue to Hospitals. This meant that the requirements for joining the group had to be raised. By 1961, it was no longer a on the job trainee field. AAIT established standards for schools. In 1963, representatives from American Medical Association, Council of Medical Education, American College of Chest Physicians (ACCP), American Registry of Inhalation Therapists (ARIT) and ASA together came to Chicago headquarters of AMA to form Board of Schools for the new field which was to function under AMA council on medical education. The Board of schools was later renamed Joined Review Committee for Inhalation Therapy Education (JRCITE) in 1964. JRCITE visited and evaluated inhalation therapy education programs. This step marked a very important step in the establishment of serious education and training programs in respiratory care as it weeded out the training programs which were ineffective and those which were exploitative. Each inhalation training program had to be approved by the JRCITE after meeting the requirements and tests and the minimum standards that had been put in place.

The evaluation programs evolved and now moved from hospitals to academic institutions. The essentials for approving a program were based on the facilities that were available for training such as books, the medical support and the number of classes. In 1980s this method of evaluation was realized to be inadequate and inaccurate. It changed its methods of evaluation from progress oriented to target oriented were the trainees were measured based on the given targets of a training programs.

While there was development of AMA approved schools for inhalation therapy, there was also establishment for system for accrediting individuals who passed the accreditation requirements. The 1959 autumn Bulletin AAIT called for the creation for a nonprofit organization that would create registration for individual practitioners and ARIT was developed. By late 1960s, the credential and title of Certified Inhalation Therapy Technician was developed.

By 1972, AAIT changed its name to American Association of Respiratory Therapists (AART). Other changes that also had been witnessed in this profession are the certification and accreditation titles. Registered Inhalation Therapist changed to Registered respiratory Therapist and Certified Inhalation Therapy Technician changed to Certified Respiratory Therapy Technician.

Other major events in history respiratory care include the formation of National Board of Respiratory Care (NBRC) in 1974 to develop and testing procedures according to the set national standards. In 1995 there was the formation of Respiratory Care Education Programs.

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