334.810. Practice of respiratory care, definition--practice, where--practice, special training required, when--rules and regulations, authority to promulgate.
Practice of respiratory care, definition--practice, where--practice,special training required, when--rules and regulations, authority topromulgate.
334.810. 1. The "practice of respiratory care" includes, but is notlimited to:
(1) The administration of pharmacologic, diagnostic and therapeuticagents related to respiratory care to implement a disease prevention,diagnostic, treatment or pulmonary rehabilitative regimen prescribed by aphysician or by clinical protocols pertaining to the practice ofrespiratory care;
(2) Observing, examining, monitoring, assessment and evaluation ofsigns, symptoms and general physical response to respiratory careprocedures, including whether such are abnormal, and implementation ofchanges in procedures based on observed abnormalities, appropriate clinicalprotocols or pursuant to a prescription by a physician licensed underchapter 334, or a person acting under a collaborative practice agreement asauthorized by section 334.104; or
(3) The initiation of emergency procedures under the regulations ofthe board or as otherwise permitted in sections 334.800 to 334.930.
2. The practice of respiratory care is not limited to the hospitalsetting but shall always be performed under the prescription, order orprotocol of a licensed physician and includes the diagnostic andtherapeutic use of the following:
(1) Administration of medical gases, except for the purpose ofanesthesia;
(2) Administration of pharmacologic agents related to, or inconjunction with, respiratory care procedures;
(3) Aerosolized medications and humidification;
(4) Arterial blood gas puncture or sample collection;
(5) Bronchopulmonary hygiene;
(6) Cardiopulmonary resuscitation;
(7) Environmental control mechanisms and therapy;
(8) Initiation, monitoring, modification of ventilator controls, anddiscontinuance or withdrawal of continuous mechanical ventilation;
(9) Intubation/extubation of endotracheal tubes, tracheostomy tubesand transtracheal catheters;
(10) Insertion of artificial airways and the maintenance of naturaland artificial airways;
(11) Mechanical or physiological ventilatory support;
(12) Point-of-care diagnostic testing;
(13) Specific diagnostic and testing techniques employed in themedical management of patients to assist in diagnosis, monitoring,treatment and research of pulmonary abnormalities, including measurement ofventilatory volumes, pressures, flows, collection of specimens of blood andmucus, measurement and reporting of blood gases, expired and inspired gassamples and pulmonary function testing;
(14) Diagnostic monitoring or therapeutic intervention for oxygendesaturation, aberrant ventilatory patterns and related sleep disordersincluding obstructive and central apnea; and
(15) Other related physiologic measurements of the cardiopulmonarysystem.
3. The practice of respiratory care may also include, with specialtraining, the following:
(1) Insertion and maintenance of peripheral arterial or venous linesand hemodynamic monitoring;
(2) Assistance with diagnostic or performing therapeuticbronchoscopy;
(3) Extracorporeal Membrane Oxygenation (ECMO), limited to theintensive care setting, and delivered under the supervision of a CertifiedClinical Perfusionist (CCP, as defined by the American Board ofCardiovascular Perfusion, an allied medical professional whose expertise isthe science of extracorporeal life support) and a licensed physician;
(4) Air or ground ambulance transport;
(5) Hyperbaric oxygenation therapy;
(6) Electrophysiologic monitoring; or
(7) Other diagnostic testing or special procedures.
4. The state board of registration for the healing arts pursuant tosection 334.125, and the board of respiratory care, created pursuant tosection 334.830, may jointly promulgate rules defining additionalprocedures recognized as proper to be performed by respiratory carepractitioners. In order to take effect, such rules shall be approved by amajority vote of a quorum of each board. Neither the state board ofregistration for the healing arts nor the board of respiratory care mayseparately promulgate rules relating to the practice of respiratory care.
(L. 1996 H.B. 999 § 2)