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introduce
With the development of modern medicine, respiratory care has been paid more and more attention by clinical departments, especially in critical care medicine, respiratory medicine, thoracic surgery, anesthesiology, pulmonary function laboratory and rehabilitation medicine. Respiratory nursing was born in the United States in 1960s, and its landmark event was the publication of Inhalation Therapy magazine. Respiratory health care physician (RCP) refers to a professional technician who, under the guidance of a doctor, uses his professional knowledge of cardiopulmonary function support and rehabilitation to give diagnosis, treatment and care to people with cardiopulmonary insufficiency or abnormality. This paper summarizes the history and main job categories of certified public accountants in China, and discusses the existing problems and development prospects of certified public accountants in China.
1 Birth of Respiratory Therapists and Respiratory Therapists With the development of medical specialties, the United States established the first respiratory therapy society in the world-American Respiratory Nursing Association (AARC) on 1947. 1947, the magazine Inhalation Therapy (the predecessor of Respiratory Nursing) sponsored by AARC was officially launched, marking the beginning of the establishment of respiratory therapy discipline. From 65438 to 0960, the National Respiratory Care Board (NBRC) became the first national institution in the world to examine the qualifications of respiratory therapists. Now the United States has built a series of complete respiratory treatment systems, including discipline construction, practice system, education and training, qualification certification and so on. Subsequently, Canada and other Central and North American countries gradually established their own Canadian Association of Respiratory Therapists (CSRT). In Asia, Taiwan Province Province of China is the first region to establish a respiratory therapy department and a respiratory therapy society.
2 The development history of respiratory therapy in China, compared with the United States and other North American countries, respiratory therapy in China started late and the development system is not perfect. In the development of respiratory therapy in China, Run Run Shaw Hospital of Zhejiang University and West China Clinical Medical College of Sichuan University are at the forefront. 65438-0993 Run Run Shaw Hospital of Zhejiang University, with the help of Malinda University in the United States and referring to the development model of respiratory therapy in the United States, established its own respiratory therapy discipline, becoming the first large-scale respiratory therapy department in mainland China. In 2000, West China Medical College of Sichuan University took the lead in setting up a college specializing in respiratory therapy in China. After more than ten years of development, West China Medical College has established a complete training model. Its training is divided into two-year medical courses and two-year respiratory therapy courses, including respiratory physiology and lung function, respiratory therapy physics, mechanical ventilation and other courses. Its graduates have been active in intensive care and respiratory medicine departments of major hospitals across the country. Subsequently, respiratory therapy was established in major hospitals all over the country. In the development process of nearly 20 years, domestic respiratory therapy has not been fully developed, lacking standardization, and the practices of hospitals are not uniform.
3 scope of work of respiratory therapy
3. 1 working place of respiratory therapists At present, domestic respiratory therapists are mainly concentrated in respiratory department, comprehensive intensive care unit, pediatric intensive care unit, emergency department, rehabilitation treatment center, anesthesiology department, thoracic surgery department, sleep treatment center, pulmonary function examination room and other departments, as well as community medical centers and family therapy and rehabilitation medical centers. A few respiratory therapists are engaged in scientific research and teaching in schools and scientific research units.
3.2 Treatment targets of respiratory therapists At present, the working targets of respiratory therapists in China are mainly patients with cardiopulmonary insufficiency or abnormality, such as patients with chronic obstructive pulmonary disease, patients with acute and chronic respiratory failure, patients with acute respiratory distress syndrome, and newborns with immature cardiopulmonary system. In addition, it also undertakes disease prevention, smoking cessation guidance and health education for the public.
3.3 Scope of business Respiratory therapists perform the following tasks under the guidance of doctors: (1) Monitoring of respiratory physiology and hemodynamics; (2) Assist doctors to establish artificial airway, including tracheal intubation and tracheotomy, and conduct tracheal intubation independently in case of emergency; (3) Mechanical ventilation: including ventilator use mode and parameter adjustment, prevention and treatment of ventilator-related complications, evaluation and implementation of mechanical ventilation evacuation; (4) artificial airway management; (5) Oxygen therapy and atomization therapy: including adjustment of oxygen concentration, selection and use of oxygen therapy devices and atomization devices, and effect evaluation; (6) Physical therapy of lung: postural drainage, chest vibration expectoration, lung dilatation therapy, etc. (7) bronchoscopy; (8) Transportation of patients with mechanical ventilation inside and outside the hospital; (9) hyperbaric oxygen chamber treatment; (10) Detection of sleep apnea.
4 Achievements of Respiratory Therapists In the current work, respiratory therapists not only improve the understanding of respiratory therapy among medical staff at all levels in the hospital and the public, but also greatly reduce the workload of medical staff. According to related research, the respiratory therapy that respiratory therapists participate in is earlier than that mediated by traditional doctors, at least two days in advance, and the related complications can be reduced by more than 50%, which can shorten the hospitalization time of patients and reduce medical expenses.
5 Development Status of Respiratory Therapy in China Although respiratory therapy in China has experienced more than 20 years of development and construction, there are still many limitations in its scope and place, and there is a lack of standardization in working methods and processes. Take the application and management of ventilators as an example. At present, there are many kinds and models of ventilators in China, and the operation process and parameter settings of each ventilator are different, which puts forward higher requirements for the use and maintenance of ventilators, and also causes certain difficulties for their training, leading to increased clinical risks. Injuries to patients due to improper use and maintenance often occur in various hospitals. At present, although colleges and universities have set up respiratory therapy specialty, it is still very small compared with China's huge population base, and the training mode of many colleges and universities is still immature and the training curriculum is not reasonable enough. Therefore, for a long time to come, respiratory therapists will face a big gap. At present, a large part of the respiratory therapists employed in China are transformed from clinical medical staff. However, these personnel lack corresponding professional training, and their level and ability are uneven. At present, there is a lack of professional title and evaluation system of respiratory therapists in China.
6 Prospects of Respiratory Therapists With the aging of China, the medical burden brought by cardiopulmonary function will gradually increase, and the respiratory therapy specialty in China will face severe challenges. In 2003, the specialty of respiratory therapy technology was formally put forward by the Ministry of Education, such as the Catalogue of Specialty in Colleges and Universities and the Outline of Medical Reform and Development in China, so as to actively improve the construction of medical related majors. At present, hospitals at all levels continue to develop sub-professional treatment and the construction of various medical centers, and respiratory therapists are bound to usher in spring.