WA Rev Code § 18.89.040 (2021)
2021 Revised Code of Washington|Title 18 - Businesses and Professions|Chapter 18.89 - Respiratory Care Practitioners.|18.89.040 - Scope of practice.

RCW 18.89.040 Scope of practice. (Effective until July 1, 2022.)(1) A respiratory care practitioner licensed under this chapter is employed in the treatment, management, diagnostic testing, rehabilitation, and care of patients with deficiencies and abnormalities which affect the cardiopulmonary system and associated aspects of other systems, and is under the direct order and under the qualified medical direction of a health care practitioner. The practice of respiratory care includes:(a) The use and administration of prescribed medical gases, exclusive of general anesthesia;(b) The use of air and oxygen administering apparatus;(c) The use of humidification and aerosols;(d) The administration, to the extent of training, as determined by the secretary, of prescribed pharmacologic agents related to respiratory care;(e) The use of mechanical ventilatory, hyperbaric, and physiological support;(f) Postural drainage, chest percussion, and vibration;(g) Bronchopulmonary hygiene;(h) Cardiopulmonary resuscitation as it pertains to advanced cardiac life support or pediatric advanced life support guidelines;(i) The maintenance of natural and artificial airways and insertion, without cutting tissues, of artificial airways, as prescribed by a health care practitioner;(j) Diagnostic and monitoring techniques such as the collection and measurement of cardiorespiratory specimens, volumes, pressures, and flows;(k) The insertion of devices to draw, analyze, infuse, or monitor pressure in arterial, capillary, or venous blood as prescribed by a health care practitioner; and(l) Diagnostic monitoring of and therapeutic interventions for desaturation, ventilatory patterns, and related sleep abnormalities to aid the health care practitioner in diagnosis. This subsection does not prohibit any person from performing sleep monitoring tasks as set forth in this subsection under the supervision or direction of a licensed health care provider.(2) Nothing in this chapter prohibits or restricts:(a) The practice of a profession by individuals who are licensed under other laws of this state who are performing services within their authorized scope of practice, that may overlap the services provided by respiratory care practitioners;(b) The practice of respiratory care by an individual employed by the government of the United States while the individual is engaged in the performance of duties prescribed for him or her by the laws and rules of the United States;(c) The practice of respiratory care by a person pursuing a supervised course of study leading to a degree or certificate in respiratory care as a part of an accredited and approved educational program, if the person is designated by a title that clearly indicates his or her status as a student or trainee and limited to the extent of demonstrated proficiency of completed curriculum, and under direct supervision;(d) The use of the title "respiratory care practitioner" by registered nurses authorized under chapter 18.79 RCW; or(e) The practice without compensation of respiratory care of a family member.Nothing in this chapter shall be construed to require that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person licensed under this chapter.[ 2011 c 235 § 2; 1999 c 84 § 1; 1997 c 334 § 4; 1994 sp.s. c 9 § 716; 1987 c 415 § 5.]NOTES:Effective dates—1997 c 334: See note following RCW 18.89.010.Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.RCW 18.89.040Scope of practice. (Effective July 1, 2022.)(1) A respiratory care practitioner licensed under this chapter is employed in the treatment, management, diagnostic testing, rehabilitation, disease prevention, and care of patients with deficiencies and abnormalities which affect the cardiopulmonary system and associated aspects of other systems, and is under the direct written, verbal, or telephonic order and under the qualified medical direction of a health care practitioner. The practice of respiratory care includes:(a) The use and administration of prescribed medical gases, exclusive of general anesthesia, including the administration of nitrous oxide for analgesia under the direct supervision of a health care practitioner;(b) The use of air and oxygen administering apparatus;(c) The use of humidification and aerosols;(d) The administration, to the extent of training, as determined by the secretary, of prescribed pharmacologic agents, including any medications administered via a nebulizer, related to cardiopulmonary care;(e) The use of mechanical ventilatory, hyperbaric, and physiological support;(f) Postural drainage, chest percussion, and vibration;(g) Bronchopulmonary hygiene;(h) Cardiopulmonary resuscitation as it pertains to advanced cardiac life support or pediatric advanced life support guidelines;(i) The maintenance of natural and artificial airways and insertion, without cutting tissues, of artificial airways, as prescribed by a health care practitioner;(j) Diagnostic and monitoring techniques such as the collection and measurement of cardiorespiratory specimens, volumes, pressures, and flows;(k) The insertion of devices to draw, analyze, infuse, or monitor pressure in arterial, capillary, or venous blood as prescribed by a health care practitioner;(l) Diagnostic monitoring of and therapeutic interventions for desaturation, ventilatory patterns, and related sleep abnormalities to aid the health care practitioner in diagnosis. This subsection does not prohibit any person from performing sleep monitoring tasks as set forth in this subsection under the supervision or direction of a licensed health care provider;(m) Acting as an extracorporeal membrane oxygenation specialist for the purposes of extracorporeal life support and extracorporeal membrane oxygenation in all critical areas, including the operating room, only if a respiratory therapist has obtained specialized education and training as determined by the secretary. Programs meeting the extracorporeal life support organization guidelines for training and continuing education of extracorporeal membrane oxygenation specialists shall be considered sufficient to meet the specialized education requirement. For the purposes of this subsection, extracorporeal membrane oxygenation specialist duties do not include the conduct and management of cardiopulmonary bypass, the incorporation of venous reservoirs, or cardiotomy suction during extracorporeal membrane oxygenation therapy; and(n) Cardiopulmonary stress testing, including the administration of medications used during cardiopulmonary stress testing.(2) Nothing in this chapter prohibits or restricts:(a) The practice of a profession by individuals who are licensed under other laws of this state who are performing services within their authorized scope of practice, that may overlap the services provided by respiratory care practitioners;(b) The practice of respiratory care by an individual employed by the government of the United States while the individual is engaged in the performance of duties prescribed for him or her by the laws and rules of the United States;(c) The practice of respiratory care by a person pursuing a supervised course of study leading to a degree or certificate in respiratory care as a part of an accredited and approved educational program, if the person is designated by a title that clearly indicates his or her status as a student or trainee and limited to the extent of demonstrated proficiency of completed curriculum, and under direct supervision;(d) The use of the title "respiratory care practitioner" by registered nurses authorized under chapter 18.79 RCW; or(e) The practice without compensation of respiratory care of a family member.Nothing in this chapter shall be construed to require that individual or group policies or contracts of an insurance carrier, health care service contractor, or health maintenance organization provide benefits or coverage for services and supplies provided by a person licensed under this chapter.[ 2021 c 114 § 3; 2011 c 235 § 2; 1999 c 84 § 1; 1997 c 334 § 4; 1994 sp.s. c 9 § 716; 1987 c 415 § 5.]NOTES:Effective date—2021 c 114: See note following RCW 18.89.010.Effective dates—1997 c 334: See note following RCW 18.89.010.Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.