Respiratory therapists: Key caregivers on COVID-19 team

As San Antonio experiences a second surge of COVID-19, the city will be even better prepared as more respiratory care graduates from the School of Health Professions have entered the workforce.

“I am excited to have these highly trained professionals join the front lines, helping patients overcome COVID-19 and other respiratory illnesses in our community,” said Richard Wettstein, MMEd, RRT, FAARC, associate professor and director of the respiratory care program, based in the School of Health Professions.

“Most people think of doctors and nurses as being on the forefront caring for patients with COVID-19, and they’re right. But respiratory therapists also play a significant role in caring for the sickest patients,” said David Shelledy, PhD, RRT, FAARC, FASAHP, dean of the School of Health Professions and a registered respiratory therapist.

Cardiopulmonary disease

Respiratory therapy is the allied health profession that provides care to patients with cardiopulmonary diseases including asthma, emphysema, chronic obstructive pulmonary disease, pneumonia, cystic fibrosis, respiratory distress syndrome and other conditions.

In the last four months, respiratory therapists have been playing a major role in treating hospitalized patients with COVID-19. “When COVID gets really bad it evolves into acute respiratory distress syndrome or ARDS, one of the most complex ventilation problems that we see,” Dr. Shelledy said.

“Respiratory therapists understand how to keep patients breathing. They are skilled in how to manage modern mechanical ventilators that can have as many as 15 to 20 different modes of ventilation,” he said.

Because patients can become so sick, ventilators must be programmed to the individual needs of each patient. Fortunately, only about 5% of COVID-19 patients need ventilators and so far, San Antonio and Bexar County have been able to maintain an adequate supply to meet the needs.

Alumni working on the front lines

David Guerrero and his wife, Hadier Morsey, graduated from the respiratory care program in 2015 and were comfortable treating patient in San Antonio. However, once the pandemic began and news reports captured the need for health care assistance in places hard hit by the virus, they both felt the need to help in a more meaningful way.

“My wife came to me one day and simply stated she had a desire to go to a crisis zone and see if we could help. Funny thing is, I had been thinking the same thing,” Guerrero said. “What drew us really was the challenge to try to bring our skills to a whole new front and to see if we could use this experience to grow our knowledge.” They volunteered to treat patients at Hackensack University Medical Center in New Jersey.

They work in several areas of the hospital including the Emergency Department, the intensive care unit and on general medicine floors with patients who have COVID-19 and other respiratory illnesses. “Care for the patients ranges from simple oxygen therapy to invasive ventilation of critically ill patients utilizing nitric oxide and positioning techniques to optimize oxygenation,” he said.

“Every day has been different, and the daily assignments change. The only thing I can say that sticks out from day to day is the lack of recovery of our ICU patients. It seems as though progress is stalled and there is a realization that patient conditions are not reversing,” he said.

“Unfortunately, a good number of patients have passed. It has been just palpable the amount of burnout, the stress and just the sadness that staff has been feeling, working in that atmosphere. It seems negative to have that takeaway from this experience, but in a way it has been a lesson learned. This disease is serious and does have lethal capacity. It deserves critical attention and caution,” Guerrero said.

Alumna Laura Freeman is working in Denver at a trauma hospital. “We’ve had our share of ventilated COVID-19 patients,” she said. “I feel like we’ve seen some patients who had very grave conditions pull through this disease.”

Educational resources for frontline health providers

Because of the seriousness of the situation, Dr. Shelledy has teamed up with UT Health San Antonio colleague Jay Peters, MD, chief of the Division of Pulmonary and Critical Care Medicine, to offer free resources to medical and health care personnel on how to assess and treat COVID-19 patients who may need the assistance of mechanical ventilators. The pair have written two books together in the past, “The Essentials of Mechanical Ventilation,” published in 2019, and “Respiratory Care: Patient Assessment and Care Plan Assessment,” published in 2016.

The free materials include a YouTube video and 1,000-slide PowerPoint deck that discuss when to start a patient on a ventilator, how to initiate and adjust ventilation, and examples of how to use various ventilators. “This is being provided as a public service to clinicians, faculty and students. Dr. Peters and I receive no royalties for these materials,” Dr. Shelledy said.

Respiratory Care program

When it was initiated in 2015, UT Health San Antonio’s master’s degree in respiratory care was the fourth of its kind in the nation. It is now one of only five entry into the profession master’s degree programs in respiratory care in the U.S. The degree provides deeper knowledge, critical thinking skills and advanced clinical education than a bachelor’s degree in this field. Students have an average pass rate of 99 percent for the licensing exam.

Respiratory therapists provide care for a diverse group of patients, ranging from newborns and pediatric patients to adults and the elderly. They are involved in specialty areas of the hospital, including newborn labor and delivery, neonatal and pediatric intensive care units, sleep laboratories and adult intensive care units. They also work in home health care, rehabilitation agencies, nursing homes, sleep centers, pulmonary function laboratories, outpatient clinics, physician offices, and on emergency transport teams.

Prospective students need not have prior health care experience. The application deadline is July 15.

For more information, visit https://www.uthscsa.edu/academics/health-professions/programs/respiratory-care-ms or call (866) 802-6288.



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Article Categories: COVID-19, Education