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CSRC Statement

AARC Videos on Mechanical Ventilation of COVID-19 To our CSRC Members,

The CSRC Board of Directors wants to address the topic of the AARC’s collaborative video series offering education to non-ICU RT extenders, who may find themselves assisting the RT in caring for large volumes of mechanically ventilated patients in the ICU. The best source of information is from the source itself, the AARC, or its State Affiliate, the CSRC.

“The AARC does NOT endorse this crisis staffing model in non-pandemic times or in facilities that are not experiencing the patient surge that makes this staffing model necessary. This is not a safe model to follow if alternative means are available. The AARC believes the best person to care for the patient's cardiopulmonary care is the respiratory therapist. The intent of this project was not to demean, demote, or discard the vital role the RT holds in healthcare.”

The CSRC would like to provide our members background on the series. The Mechanical Ventilation for COVID-19 Video Series1 was offered with the intent to provide a primer for professionals who find themselves staffing an ICU under a pandemic staffing model. In that model, the RT assumes the leadership role over a significant number of patients. The Society for Critical Care Medicine2 developed the model in response to the H1N1 pandemic leaving professionals caring for many mechanically ventilated patients on a large scale at once. The model is suggested given knowledgeable team members notify the RT when a patient's status changes. Neither the AARC nor CSRC wants anyone other than RT’s managing ventilators; however, this pandemic may leave many institutions facing unprecedented staffing issues.

California has not reported situations similar to other states inundated with cases. The AARC course does not prepare a person to operate as an RT or an independent critical care clinician, and it will not provide competency for mechanical ventilation. It provides a foundation of knowledge. The course was designed to assist RT’s on the front lines in areas that have a high number of ventilated patients that need a knowledgeable team to support their expertise.

For those concerned about RT jobs in California, the CSRC has advocated for practitioner protection such as SB-10033, that ensuring the mechanical ventilation modality requires formal respiratory education and training as defined by the Respiratory Care Board. The CSRC helped enact Title 22 of the California Code of Regulations4, which states, “Sufficient respiratory care practitioners and/or respiratory care technicians shall provide support for resuscitation and maintenance of the mechanical ventilators in a ratio of 1:4 or fewer on each shift.”

During this time of crisis, we must work together, communicate, and provide and utilize the best resources we can. Let us all share the common goals of Professionalism, Advocacy, Commitment, and Excellence. The CSRC values each of you and your dedication to Respiratory Care always. Please reach out to your professional organizations with any questions or concerns.

1. Mechanical Ventilation for Covid-19 Video Series. AARC. (2020). 2. Staff, Contact SCCM, Critical Connections Archives, All Audio iCritical Care, Critical Connections Blog, S. C. C. M. Connect, S. C. C. M. App, and Congress on Demand. "United States Resource Availability for COVID-19." 3. Respiratory therapy, S.B. 1003, Section 3702.5. State Senate (2018). 4. Acute Respiratory Care Service Staff. 22 CCR § 70405 (g). (2013).

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