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AARC In A Twit About Current Legislation Rescinding Part of the Scope of RTs and Sleep Therapy

The American Association for Respiratory Care (AARC) states that current legislation addressing sleep disorder diagnosis and treatment threatens to legally rescind part of the scope of practice of respiratory therapy.

What part of sleep disorder diagnosis do RTs have?? To my knowledge the ONLY part RTs had in sleep therapy was the set up of the xPAPs, fitting of masks, advice, support, etc. of patients. I had NO IDEA that RTs had ANY part in Dx'ing any sleep disorders!!!

The article I read didn't detail what scope RTs currently have regarding sleep disorder diagnoses. I wish they had!!

Given that so many local DME RTs often really don't know and understand the xPAPs they provide, especially the fully data capable xPAPs, other than what is on the Quick SetUp Guide, and so many don't seem to know how to do a proper mask fitting .... some extra training and qualifications don't sound like a bad idea at all to me!!!

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I thought you and Sleepy Carol were of the view that the RTs were the saving grace of the sleep industry. or was it sleep techs?
I have been wondering when this debate was going to hit this site. I just want to say that I have worked with some great RTs. It seems that there is a jurisdiction war going on between sleep and respiratory. This debate has been happening at the state level throughout the country. The 2 seem to overlap on a couple of things like CPAP and apnea. OUt of the 88 clinical sleep disorders 2 crossover industries. It seems to me that respiratory(AARC) is doing everything it can to control both industries due to this crossover. What I have been told is that it is due to the low turnout in certification by respiratory. Please keep in mind that this is 2nd hand info to me. By getting control of sleep the AARC hopes to beaf up itself. In relation to this the AASM has just recently made it easier(less expensive) fro RTs to board in sleep and crossover. It has been pretty heated on both sides. I honestly believe that the 2 industries need to merge or learn to co-exist. They compliment and benefit from one another really well. However if I am forced to pick a side I am a sleep tech and SLEEP IS NOT A LUNG FUNCTION. Being a sleep tech that has never worked as a RT I would never assume that I know how to do their job. I could only hope for the same respect. Sorry if this offended anyone. If any of you have any more insight on this please let me know.
I'll consider respecting AARC's push for a place in sleep diagnostics when respiratory degree programs start teaching something about sleep. As of now, most respiratory school grads don't know anything about sleep diagnostics or xPAP application. I understand an industry group fighting to protect its members, but this is a sham power grab.
Uh uh, Mike. Aside from our gracious RTs in this forum, it is the RPSGTs that I consider the real heroes of sleep medicine!!
if RPSGTs are the heros of sleep medicine, and I'm not saying they aren't, then they certainly are the unsung heros. after all, most people don't even know what RPSGT stands for: Registered Polysomnographic Technician or Technologist. so here's the question: what makes them special? I mean from an outside perspective: what qualities/traits do they have that make them stand head and shoulders apart in sleep medicine? is it how they're paid? how they're trained? the types of experiences they have in the sleep lab? what explains it?

Judy said:
Uh uh, Mike. Aside from our gracious RTs in this forum, it is the RPSGTs that I consider the real heroes of sleep medicine!!
They conduct the PSGs. They have to understand what they are seeing. They have to know when to intervene due to a high leak rate, loose leads, etc., etc. Eventually they qualify for scoring the tests. They HAVE to understand what the various PSG software is telling them. They also have to have SOME expertise in mask fitting. They are the ones who have to deal w/difficult patients, w/anxiety ridden patients - and many even have to strip the beds, etc. after the patient is released in the AM. Many times they encounter a patient who hasn't the slightest idea what is going on and why because the patient has had no consult w/a sleep specialist to have ANY idea of what is going to transpire. The patient wants explanations and often the RPSGTs are restricted in what they can say by their lab manager or sleep specialist. Too many times the RPSGT is the ONLY sleep professional the patient has any contact with. And they have to do all this in just ONE night of sleep evaluation or ONE night of titration. When you think about it, it really is a bit of a wonder that our RPSGTs get as accurate a titration as they do w/one night of "sleep" under unnatural conditions for first time patients.

I know sleep doctors are SUPPOSED to score the studies for themselves in addition to the RPSGTs' scoring - but - SNORT - there are an awful lot of them that just sign off on the RPSGT's scoring. Who see sleep medicine as an easy "cash cow". They gorge and purge their sleep training, don't bother to consult w/the patients at all and dictate their reports based on the RPSGT's scoring and send their interpretation to the referring doctor to handle the details w/the patient.

Then the patient is handed over to the local DME supplier - MAYBE even to the local DME supplier's RT, but even the local DME suppliers are only required to have an RT available on staff, their RT doesn't necessary have to be the one to set up the xPAP, etc.

I am sure there are some poor RPSGTs but overall the RPSGTs are the best of an not always so good lot. Sleep medicine has a long way to go in improving the sleep disorder medicine profession. Just my opinion. Formed by my own personal expeirence and the experiences of so many in these various sleep apnea support forums. The fewest complaints and problems involve RPSGTs.
i don't disagree. I guess it didn't really occur to me that RPSGTs would have experience settting/adjusting different models and types of xPAP machines and face masks. but i suppose they would, huh, from doing the titration studies?

Judy said:
They conduct the PSGs. They have to understand what they are seeing. They have to know when to intervene due to a high leak rate, loose leads, etc., etc. Eventually they qualify for scoring the tests. They HAVE to understand what the various PSG software is telling them. They also have to have SOME expertise in mask fitting. They are the ones who have to deal w/difficult patients, w/anxiety ridden patients - and many even have to strip the beds, etc. after the patient is released in the AM. Many times they encounter a patient who hasn't the slightest idea what is going on and why because the patient has had no consult w/a sleep specialist to have ANY idea of what is going to transpire. The patient wants explanations and often the RPSGTs are restricted in what they can say by their lab manager or sleep specialist. Too many times the RPSGT is the ONLY sleep professional the patient has any contact with. And they have to do all this in just ONE night of sleep evaluation or ONE night of titration. When you think about it, it really is a bit of a wonder that our RPSGTs get as accurate a titration as they do w/one night of "sleep" under unnatural conditions for first time patients.

I know sleep doctors are SUPPOSED to score the studies for themselves in addition to the RPSGTs' scoring - but - SNORT - there are an awful lot of them that just sign off on the RPSGT's scoring. Who see sleep medicine as an easy "cash cow". They gorge and purge their sleep training, don't bother to consult w/the patients at all and dictate their reports based on the RPSGT's scoring and send their interpretation to the referring doctor to handle the details w/the patient.

Then the patient is handed over to the local DME supplier - MAYBE even to the local DME supplier's RT, but even the local DME suppliers are only required to have an RT available on staff, their RT doesn't necessary have to be the one to set up the xPAP, etc.

I am sure there are some poor RPSGTs but overall the RPSGTs are the best of an not always so good lot. Sleep medicine has a long way to go in improving the sleep disorder medicine profession. Just my opinion. Formed by my own personal expeirence and the experiences of so many in these various sleep apnea support forums. The fewest complaints and problems involve RPSGTs.
Oh, I don't know that RPSGTs know all that much about the various brands and models of xPAPs and their capabilities and options, Mike. I didn't mean to imply that they did - or didn't. But they certainly would understand the software graphs, etc. Well .. I don't know about the Respionics software bar graphs but certainly the Resmed detailed graphs.
My only experience with an RT was from my first DME that gave me an M series Plus machine and told me that it would provide detailed data and was the latest and greatest of the machines out there. Little did I know. I think sleep techs do a good job as they are on the front lines so to speak.
my ultimate question is who is best equipped to deal with tweaks/modifications to the mask interface and machine and to troubleshoot patients' problems, which inevitably arise. we know it's not the sleep doctor; we know it's not the DME (except for Daniel Levy -- who is in a league of his own), so the question is who is it?
It is definatley not this sleep tech. Not yet anyway.

Mike said:
my ultimate question is who is best equipped to deal with tweaks/modifications to the mask interface and machine and to troubleshoot patients' problems, which inevitably arise. we know it's not the sleep doctor; we know it's not the DME (except for Daniel Levy -- who is in a league of his own), so the question is who is it?
why isn't it the sleep tech? is it because it's not in their job description yet and don't get paid for it yet (totally understandable if that's the case, by the way), or is it because sleep techs lack the expertise?

Rock Hinkle said:
It is definatley not this sleep tech. Not yet anyway.

Mike said:
my ultimate question is who is best equipped to deal with tweaks/modifications to the mask interface and machine and to troubleshoot patients' problems, which inevitably arise. we know it's not the sleep doctor; we know it's not the DME (except for Daniel Levy -- who is in a league of his own), so the question is who is it?

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