Current through Register Vol. 56, No. 18, September 16, 2024
(a) For the purposes of treating, managing,
controlling, and caring for patients with deficiencies and abnormalities of the
cardiac and pulmonary system, a respiratory care practitioner may perform the
following duties under the direction or supervision of a physician, physician
assistant, or advanced practice nurse:
1. Use
of medical gases, air and oxygen-administering apparatus;
2. Use of environmental control
systems;
3. Use of humidification
and aerosols;
4. Administration of
drugs and medications;
5. Use of
apparatus for cardiopulmonary support and control;
6. Bronchial hygiene techniques such as:
i. Postural drainage;
ii. Chest percussion; and
iii. Vibration;
7. Breathing exercises;
8. Cardio and/or pulmonary
rehabilitation;
9. Performance of
cardiopulmonary resuscitation;
10.
Maintenance of natural and mechanical airways;
11. Insertion and maintenance of artificial
airways and insertion and maintenance of peripheral arterial and peripheral
venous catheters;
12. Testing
techniques to assist in diagnosis, monitoring, treatment, and research
including, but not limited to:
i. Measurement
of cardiopulmonary volumes, pressure, and flow;
ii. Drawing and analyzing of samples of
arterial, capillary, and venous blood; and
iii. Apnea testing and monitoring;
and
13. Hyperbaric
oxygenation.
(b) A
respiratory care practitioner may perform the following duties under the
direction or supervision of a physician, physician assistant, or advanced
practice nurse:
1. Educate patients and
caregivers about respiratory care procedures as part of a patient's disease
management program; and
2. Provide
professional consultation services to health care, educational, and community
organizations, and State and local agencies.
(c) For purposes of this subchapter, "under
the direction of a physician, physician assistant, or advanced practice nurse"
means that respiratory care shall not be rendered unless one of the following
conditions is met:
1. The licensee has
obtained a written order or prescription from a plenary licensed physician,
physician assistant, or advanced practice nurse, or from such other health care
practitioner authorized by law to prescribe or order respiratory
care;
2. The licensee has
documented the physician, physician assistant, or advanced practice nurse's
clearance for treatment of the patient, which may include the physician,
physician assistant, or advanced practice nurse's countersigning of the
respiratory care practitioner's proposed plan of treatment;
3. The licensee has followed the respiratory
care protocols established by the health care facility at which he or she
practices; or
4. The licensee has
received a verbal order or prescription, in person or by telephone. In an
outpatient setting, the verbal order or prescription shall be memorialized by
the prescriber in writing within two weeks. In an inpatient setting, the verbal
order or prescription shall be memorialized by the prescriber within 24
hours.
(d) In no case
will physician, physician assistant, or advance practice nurse direction be
construed to have been provided on the basis of a patient's representation that
he or she has obtained a physician, physician assistant, or advanced practice
nurse's clearance.
(e) For the
purposes of this subchapter, "under the supervision of a physician, physician
assistant, or advanced practice nurse" means that respiratory care shall not be
rendered unless a physician, physician assistant, or advanced practice nurse is
constantly accessible, either on-site or through electronic communication, and
available to render physical assistance when required.
