Institute for Continuing Education

Patient Assessment Skills for Therapist Driven Protocols

Course Objectives

Upon successful completion of this module, you will be able to:

• Define therapist-driven protocols (TDPs) and explain their role in optimizing respiratory care delivery within the contemporary healthcare environment.
• Apply systematic frameworks for comprehensive patient assessment that integrate subjective and objective data to guide clinical decision-making.
• Demonstrate understanding of the legal, ethical, and professional scope of practice considerations governing respiratory therapist assessment activities.
• Conduct a thorough patient interview utilizing evidence-based communication techniques to elicit relevant respiratory symptoms, medical history, and psychosocial factors.
• Analyze the significance of chief complaint, history of present illness, past medical history, medications, allergies, social history, and review of systems in formulating assessment conclusions.
• Recognize how health literacy, cultural competence, and patient-centered communication influence the quality of historical data obtained.
• Perform a systematic physical examination of the chest and respiratory system using inspection, palpation, percussion, and auscultation techniques.
• Identify and interpret normal and abnormal breath sounds, adventitious sounds, and their clinical correlations with underlying pathophysiology.
• Assess vital signs, oxygenation status, work of breathing, and signs of respiratory distress to determine acuity and guide therapeutic interventions.
• Interpret chest radiographs systematically, identifying normal anatomy and common pathological findings relevant to respiratory care.
• Describe the indications, advantages, and limitations of advanced imaging modalities including computed tomography, point-of-care ultrasound, and magnetic resonance imaging in pulmonary assessment.
• Integrate imaging findings with clinical data to support protocol-based treatment decisions.
• Analyze arterial blood gas results, including acid-base status, oxygenation indices, and ventilation parameters, to guide respiratory interventions.
• Interpret pulse oximetry, capnography, and transcutaneous monitoring data within clinical context, recognizing limitations and sources of error.
• Evaluate the clinical utility of sputum analysis, complete blood count, basic metabolic panel, cardiac biomarkers, and inflammatory markers in pulmonary patient assessment.
• Describe the indications, techniques, and interpretation of spirometry, lung volumes, diffusing capacity, and bronchoprovocation testing.
• Apply pulmonary function test results to differentiate obstructive, restrictive, and mixed ventilatory defects.
• Utilize bedside pulmonary mechanics and respiratory muscle strength assessments in critically ill patients.
• Synthesize assessment findings to formulate clinical impressions that drive protocol selection and modification.
• Document assessment findings accurately and communicate effectively with the interprofessional healthcare team.
• Apply quality improvement principles to evaluate and enhance assessment practices within therapist-driven protocol frameworks.

Course Information

Pulmonary pharmacology involves the therapeutic use of drugs that affect the lungs and are delivered by a variety of modalities. RCPs need to have a general knowledge of the drugs (agents) most commonly used to treat respiratory problems, an in-depth knowledge of airway pharmacology and the equipment utilized for delivery of the medications.

The care of patients with pulmonary diseases involves utilizing a wide spectrum of drugs to provide everything from emergency interventions for acutely and critically ill persons, to administering maintenance support for a relatively stable patient.

RCPs are primarily involved in administering drugs that are specifically designed to treat the so-called pathological triad of pulmonary disease: bronchospasm, airway inflammation, and retained secretions. However, since the respiratory system cannot be disassociated from cardiac and vascular systems, respiratory care pharmacology necessarily involves a relatively broad scope of drug classes.

The front line arsenal for treating pulmonary diseases consists of bronchodilators, antimuscarinics, corticosteroids, mucokinetics, mucolytics, and decongestants. There are also a variety of other agents available for treating pulmonary ailments, including oxygen, antibiotics, local anesthetics, respiratory stimulants, and muscle relaxants. Because of the inter-connectedness of the body systems, additional groups of drugs that may be administered to patients with respiratory diseases include anti-infectives, CNS drugs, antiarrhythmic agents, anticoagulants, antihypertensives, and diuretics.

In this course you will be asked to complete a multiple choice final exam, and several case studies involving clinical scenarios. Unless you complete all of these, you cannot receive the full unit credit for this course.

The course includes detailed discussions of aerosol therapy, nebulizers, humidifiers, and a variety of medications used in the treatment of respiratory disorders and diseases. Therapeutic procedures and medication functions are also examined in this valuable continuing education unit. The resources drawn upon and synthesized for the following material can be found in the References sections.