Current through Register Vol. 56, No. 6, March 18, 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.
