he Committee on Respiratory Care serves a very important role in our ASA. The committee takes on special projects and assists the ASA Board of Directors on recommendations related to the field of respiratory care and recommends liaisons to the national respiratory care organizations.

In an advisory role for the ASA Board of Directors, our committee recently was asked to assist the Board on a position regarding tobacco smoking cessation, particularly during the peri-operative period. This is a time when patients are more willing to stop tobacco use, at least until their surgery is over. Based upon positive outcomes research by David O. Warner, M.D., and recent reimbursement opportunities through Medicare for smoking cessation, our Society is interested in evaluating this position further. Our committee therefore has this under review and is monitoring what our role should be in this endeavor.

Hot topics where respiratory therapists need our support include polysomnography and sleep laboratories. These laboratories are increasing across the United States. Respiratory therapists are well-trained in airway management, and the polysomnography option is becoming available at an increasing number of respiratory care educational programs across the country. Certainly as patients with known sleep apnea come to our operating rooms, skilled assistance could be solicited from respiratory therapists both preoperatively in assessment of the patient and in our postoperative care unit. Overall this is basically a “scope of practice” issue for respiratory therapists, and we need to fully support them in this endeavor.

Another very important mission for our committee is to identify and recommend ASA members with a strong interest in respiratory care to our ASA Board of Directors for appointments as liaisons to various respiratory care organizations such as the National Board of Respiratory Care (NBRC), the Committee on Accreditation for Respiratory Care (CoARC) and the American Association for Respiratory Care (AARC) Board of Medical Advisors (BOMA).

To bring everyone up to speed on these respiratory organizations, a brief description follows:

NBRC is a voluntary health-certifying board that was created in 1960 to evaluate the professional competence of respiratory therapists. Its Web site is <www.nbrc.org>.

CoARC is sponsored by the American Association of Respiratory Care, the American College of Chest Physicians, ASA and the American Thoracic Society. The mission of CoARC, in collaboration with the Commission on Accreditation of Allied Health Programs (CAAHEP), is to promote quality respiratory therapy education through accreditation services. Its Web site is <www.coarc.com>.

AARC is the national and international professional association for respiratory care, and BOMA is the governing board of medical advisors to AARC. Its Web site is <www.aarc.com>.

The active involvement by anesthesiologists within these organizations could not be more important than it is today. Anesthesiologists have lost ground in medically directing respiratory care departments within our hospitals, while our need to work closely with our allied health colleagues has grown. We are realizing (again) that we need to take a more active role in our hospitals’ intensive care units. With this, our need and desire to work with respiratory therapists has increased.

Specifically the respiratory therapist is most helpful to us in the intensive care unit (ICU), weaning critically ill patients from mechanical ventilation. Furthermore, respiratory therapists can assist us with the handling of difficult airways, particularly when we are out of the operating rooms, whether it be during a code situation or an elective intubation. It is most comforting to have a knowledgeable, well-trained respiratory therapist working beside you in these difficult and often isolated environments. As we make a concerted effort to have our residents and staff spending more time in the ICU, we need support from respiratory care. ASA’s contribution in helping our respiratory care colleagues achieve higher levels of academic excellence, improved testing and standardization of skill sets as well as political support is important to all of us.

In the past, we have been fortunate to have strong liaisons from our ASA representing us at these respective respiratory care organizations. Unfortunately this has been a somewhat thankless position in the past. I am glad that we have the opportunity to identify our ASA liaisons to these respective organizations. Their names and organizations are listed below:

BOMA: Chair Robin J. Elwood, M.D., Robert W. Gould, M.D., William Bernhard, M.D., and Clifford E. Boehm, M.D.

CoARC: Past President Ian J. Gilmour, M.D., and Manuel R. Castresana, M.D.

NBRC: President Robert A. May, M.D., Theodora K. Nicholau, M.D., Ph.D., Stephen R. Stayer, M.D., David S. Bronheim, M.D., and Thomas M. Fuhrman, M.D.

I was a registered respiratory therapist (RRT) prior to entering medical school, and I have had the pleasure of being the Medical Director of Respiratory Care at the Massachusetts General Hospital for nine years. My current institution is not unlike the majority of institutions today, where the medical directorship of respiratory care is under pulmonary medicine. Therefore, having an opportunity to chair this committee has had special meaning to me, and I can speak for our entire committee that we all feel that respiratory therapists are vital to our maintaining high quality patient care. Our committee feels strongly that we should fully support the efforts of our closest allied partner in health care.

I would suggest that if you have interest in working with our committee, please contact me at <ahead@mcg.edu> or contact our ASA leadership and join our committee. We are always looking for interested committee members who share this common goal.

C. Alvin Head, M.D., RRT, is Professor and Chair, Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta, Georgia.