Being treated for chronic obstructive pulmonary disease (COPD) in an emergency department can be overwhelming. When putting together a plan for management, many patients and caregivers know little about the support respiratory therapists can provide when breathing difficulties land them in the hospital. We spoke with Mandy De Vries, a registered respiratory therapist (RRT) who has worked in adult, pediatric and neonatal critical care units, as well as emergency departments and is part of an extracorporeal membrane oxygenation (ECMO) team since 2017, about how patients with COPD benefit from having a RRT on their healthcare team.

Q: What is a Registered Respiratory Therapist (RRT)?

A RRT is a licensed healthcare professional that is specifically trained to care for patients with respiratory and cardiopulmonary disorders. Under the direction of a physician, they evaluate and treat illnesses, such as COPD, by finding the correct balance of medication, therapies, advanced technology (such as ventilators) and lifestyle changes. During breathing emergencies, RRTs have the expertise to assess a patient’s condition and provide the best course of treatments. From critically ill patients in an intensive care unit (ICU) to pediatric patients who require educational support for better inhalation techniques, RRTs work across various settings to monitor their patients’ progress and ensure proper ongoing care is provided. With this diverse set of skills, RRTs act as a bridge between patient and primary doctors allowing them optimal care throughout their recovery process.

Mandy De Vries, MSc., RRT, RRT-NPS,
AARC Director of Education Mandy De Vries, MSc., RRT, RRT-NPS, AARC Director of Education

Q: When someone with COPD is rushed into the emergency department, what role does a RRT play?

RRTs play a critical role during emergencies involving people with COPD. If the patient is struggling to breathe, a RRT applies their specialized knowledge and skills to help diagnose the breathing issue and assist doctors with treatments, such as administering medication or therapies that may help open blocked airways. At times where every second counts, it is crucial for RRTs to intervene swiftly to improve oxygen levels and reduce inflammation of the airway.

Q: What sort of symptoms would require hospitalization for COPD and how does the RRT support the hospital stay?

COPD is a serious condition that can worsen quickly and can require hospitalization if symptoms flare up. Common COPD-related symptoms like severe shortness of breath, changes in blood oxygen levels, persistent coughing, rapid breathing and high fever can potentially require urgent hospital care. During the hospital stay, RRTs will support the patient by providing treatments such as inhaled medications and oxygen therapy, as well as consistently monitoring lung function. Additionally, RRTs provide education to patients and their families on how to recognize signs of worsening COPD so they can navigate their condition with confidence and seek care before it becomes an emergency.

Q: What part can a RRT play when the patient is discharged?

A RRT’s primary responsibility is to help manage both short and long-term symptom relief with effective treatment goals and patient education. As part of this process, they may lead pulmonary rehab courses, perform pulmonary function testing, provide oxygen therapy suggestions and techniques, set up home monitoring systems to help manage symptoms better and suggest ways to conserve energy, as well as assess environmental risks such as air pollution or mold that could trigger COPD flare-ups. Ultimately their goal is to promote an improved quality of life for those who suffer from COPD by enabling them to independently manage their own care while they are at home.

Q: COPD is a leading cause of hospitalization. What is something you wish people living with COPD knew to help avoid hospitalization?

As a RRT and a family member of a loved one with COPD, I have seen firsthand how debilitating COPD can be for patients. I want people to know that there are practical steps they can take to help manage their COPD and avoid unnecessary hospitalizations. In fact, understanding and applying healthy habits can give people living with this condition the best chance of avoiding emergencies. For instance, practicing good disease management by:

  • Regularly taking prescribed medications;
  • Seeing your doctor for regular checkups;
  • Keeping up with vaccinations;
  • Knowing the signs of an infection or flare-up and seeking medical help as soon as possible if needed;
  • Avoiding triggers like dust, smoke and fumes;
  • And getting plenty of exercise.

Staying informed about lifestyle changes and understanding your personal COPD needs will make it easier to better manage it daily, which makes all the difference when it comes to reducing hospitalization due to COPD.

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