Respiratory therapy is a specialized healthcare field where trained clinicians assess, treat.
You probably don’t think about breathing until you can’t. A sudden asthma flare, a bout of pneumonia, or the slow creep of COPD changes that. Suddenly every breath feels like work, and the person who shows up at the bedside adjusting the oxygen mask or checking the ventilator settings is a respiratory therapist (RT).
So what is respiratory therapy, exactly? It’s a dedicated branch of medicine focused on the lungs and airways. RTs don’t do general nursing or primary care — they’re the specialists who handle everything from inhaled medications to critical ventilator management. And their role has become more visible than ever as the population ages and respiratory conditions multiply.
What Respiratory Therapists Actually Do
Respiratory therapists assess, treat, and care for patients with breathing disorders. According to the Bureau of Labor Statistics, they “assume primary responsibility for all respiratory care modalities” — meaning they’re the go-to clinicians for oxygen delivery, aerosol medications, chest physiotherapy, and airway clearance.
In a hospital setting, RTs work alongside ICU physicians and nurses to manage patients on ventilators or those with complicated oxygenation needs. They perform diagnostic tests to measure lung capacity and function, interpret the results, and adjust treatments accordingly. Outside the ICU, they help patients with chronic conditions like asthma learn to use inhalers correctly or participate in pulmonary rehabilitation programs.
One lesser-known technique RTs use is the TEE (or “huff cough”) airway clearance method. It involves three or four slow, deep inhalations through the nose, a short pause, and then a controlled exhalation — a gentler alternative to forceful coughing that helps clear mucus without collapsing airways.
Why the Role Gets Confused With Nursing
Many people assume RTs and registered nurses (RNs) do the same job, especially in critical care. The overlap is real — both work at the bedside and collaborate closely. But their scopes are distinct. Nurses focus on overall well-being, medication administration, wound care, and broad medical management. RTs strictly practice cardiopulmonary care. They are the experts in lung mechanics, ventilator settings, and gas exchange.
- Oxygen therapy: RTs determine the correct flow and delivery method (nasal cannula, face mask, or high-flow system) based on the patient’s oxygen saturation.
- Mechanical ventilation: They set the ventilator’s rate, volume, pressure, and oxygen concentration, then monitor the patient’s response and adjust as needed.
- Aerosol medications: RTs administer inhaled bronchodilators (like albuterol) and anti-inflammatory drugs via nebulizers or metered-dose inhalers.
- Pulmonary rehabilitation: They lead programs that combine exercise training, education, and breathing retraining for people with chronic lung disease.
- Diagnostic testing: RTs perform spirometry, blood gas analysis, and other tests to assess lung function and guide treatment plans.
Salary also differs. Estimates show RTs earn roughly $78,000 annually, while RNs average around $86,000 — though hospital-based RTs can earn up to $80,660 on average per BLS data. Work environments vary too: RTs are concentrated in acute-care hospitals, while RNs have more diverse settings from clinics to home health.
Conditions Respiratory Therapy Covers
Respiratory therapists work with a wide range of patients. The NCI Dictionary of Cancer Terms defines respiratory therapy as exercises and treatments that help Improve or Restore Lung Function — a broad goal that applies to many diagnoses. Common conditions include asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, cystic fibrosis, pneumonia, and respiratory distress in premature newborns.
RTs also handle emergency situations: trauma patients with collapsed lungs, people with severe allergic reactions affecting breathing, and those with acute respiratory failure. In the NICU, they manage ventilators for premature infants whose lungs aren’t fully developed. The demand is growing as the population ages and chronic respiratory diseases become more common.
| Condition | How RTs Help | Common Treatments |
|---|---|---|
| Asthma | Education on inhaler use, peak flow monitoring, acute flare management | Bronchodilators, inhaled steroids, oxygen |
| COPD | Pulmonary rehab, oxygen therapy, breathing exercises | Long-acting bronchodilators, supplemental oxygen, chest physiotherapy |
| Sleep apnea | CPAP/BiPAP setup and titration, home equipment training | Positive airway pressure devices |
| Cystic fibrosis | Airway clearance techniques (chest PT, TEE), medication delivery | Mucolytics, bronchodilators, oscillatory vest |
| COVID-19 / ARDS | Ventilator management, proning, oxygenation monitoring | Mechanical ventilation, prone positioning, high-flow oxygen |
These conditions share a common thread: they all interfere with the basic exchange of oxygen and carbon dioxide. RTs are trained to identify the specific mechanism—whether it’s airway narrowing, mucus plugging, or ventilation-perfusion mismatch—and choose the appropriate intervention.
How to Become a Respiratory Therapist
Entering the field typically requires an associate or bachelor’s degree in respiratory therapy from an accredited program. After graduation, candidates must pass the national exam to become a Certified Respiratory Therapist (CRT) and often pursue the Registered Respiratory Therapist (RRT) credential for advanced opportunities. Licensure is mandatory in most states.
- Earn a degree: Accredited programs cover anatomy, physiology, pharmacology, and clinical practice. Many community colleges offer two-year associate degrees; universities offer four-year bachelor’s programs.
- Pass the national exam: The CRT exam tests knowledge of patient assessment, equipment, and therapeutic procedures. The RRT exam is a step up, requiring deeper clinical reasoning.
- Apply for state licensure: States like Louisiana have moved to a single category (Licensed Respiratory Therapist), simplifying the process. Requirements vary, so check your state board.
- Consider advanced practice: Some states are exploring an Advanced Practice Respiratory Therapy (APRT) role, similar to nurse practitioners, which would allow RTs to manage a broader scope of care.
The U.S. Public Health Service requires a bachelor’s or master’s degree from a program accredited by the Committee on Accreditation of Respiratory Care. This pathway leads to positions in federal agencies and public health settings, often with higher responsibility and pay.
Tools and Techniques in Respiratory Therapy
RTs use a wide array of equipment and methods. Mechanical ventilation is one of the most critical tools — it helps patients breathe or breathes for them when their lungs fail. The ventilator delivers oxygen, removes carbon dioxide, and keeps airways open. RTs choose between modes like volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). A 2002 study found that PCV offers no clear advantage over VCV in patients who aren’t breathing spontaneously, though newer research may update that recommendation.
Another core tool is oxygen therapy, which provides supplemental oxygen through various interfaces. Pulmonary rehabilitation programs blend exercise training, breathing retraining, and education — an approach that can improve quality of life for people with chronic lung disease. Chest physiotherapy involves manual techniques or mechanical devices to loosen mucus in the airways.
The Commissioned Corps of the U.S. Public Health Service outlines education standards for RTs, requiring accreditation through the Committee on Accreditation of Respiratory Care. This ensures that RTs entering federal service have met rigorous training and clinical competency requirements.
| Tool / Technique | Purpose |
|---|---|
| Mechanical ventilator | Delivers breaths and removes CO2 when patient can’t breathe adequately |
| Oxygen delivery devices | Provide supplemental oxygen at controlled flow rates |
| Nebulizer | Converts liquid medication into a fine mist for inhalation |
| Chest physiotherapy | Uses percussion, vibration, or devices to clear mucus |
| Blood gas analyzer | Measures pH, oxygen, and CO2 levels in blood for real-time ventilation guidance |
These tools are often used together. For example, a post-operative patient might receive oxygen therapy, chest physiotherapy to prevent pneumonia, and blood gas monitoring to ensure adequate ventilation — all managed by the same RT.
The Bottom Line
Respiratory therapy is a specialized, hands-on healthcare field that focuses on helping people breathe better. RTs treat everything from asthma attacks to ventilator-dependent ICU patients, working closely with physicians and nurses. The field offers solid career growth, with hospital RTs averaging around $80,660 per year and demand rising as chronic lung conditions become more common.
If you or a family member is facing a lung condition — whether it’s COPD, sleep apnea, or recovery from pneumonia — an RT is likely part of your care team. For personalized advice on which breathing treatments fit your specific diagnosis, your pulmonologist or primary care doctor can connect you with the respiratory therapy services best matched to your lung function test results.
References & Sources
- Cancer. “Respiratory Therapy” The NCI Dictionary of Cancer Terms defines respiratory therapy as “exercises and treatments that help improve or restore lung function.”.
- Usphs. “Respiratory Therapist” The Commissioned Corps of the U.S.