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Indiana Respiratory Therapy — Requirements & Free Practice

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Respiratory Care Practitioner License

Ordinary respiratory care practitioner license. Current issuance is governed by IC 25-34.5-2-8, -9 and -11; the former section 12 examination provision was repealed effective July 1, 2026. IC 25-1-21 excludes respiratory care; IC 25-1-5.7 expired with the COVID-19 public health emergency. The volunteer registry under IC 25-22.5-15 depends on the licenses enumerated in IC 34-30-13-1.2, which do not include respiratory care licenses.

Licensing authority: Indiana Respiratory Care Committee / Medical Licensing Board of Indiana · Application information

Renewal or reinstatement after a first continuing education noncompliance notice
No examination is required for this applicant pathway.
Compliance
Supply proof of compliance under IC 25-1-4-5(b)(1) or IC 25-1-8-6 as applicable. The Board then reinstates the license or renews it in place of the conditional license.
Credit
Make-up hours cannot also count toward the current license-period CE requirement under IC 25-1-4-7.
Notice
Following notice, seek review within 21 days if compliance is disputed, or pay the Board-imposed civil penalty within 21 days and acquire missing hours within six months.
Penalty
Ordinary penalty is up to $1,000; knowingly or intentionally false CE statements may produce an additional penalty up to $5,000.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after repeat continuing education noncompliance and denied renewal
No examination is required for this applicant pathway.
Credit
Make-up hours cannot also count toward the current license-period CE requirement.
Prior notice
The practitioner received a CE noncompliance notice in the preceding license period and renewal or reinstatement was denied on repeat noncompliance.
Restoration
Pay a Board-determined civil penalty up to $1,000, acquire the hours required for the relevant license period, and otherwise comply with IC 25-1-4.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement with a discretionary education waiver
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education waiver
The Committee may waive the education requirements when the applicant has actively practiced respiratory care including actual patient care in another jurisdiction under a physician licensed there for at least 10 of the preceding 15 years, and the Committee determines sufficient knowledge and experience. Submit a detailed supervised-practice history. This waiver is of education, not the examination requirement incorporated from section 8.
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Issuance
The Committee must issue a license by endorsement within 30 days after the application is filed and completed.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Prior qualification
Hold an eligible respiratory care license or certification or credentials from a Committee-approved national respiratory care practitioner organization under IC 25-34.5-2-11(a)(1).
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Licensure by endorsement of a respiratory care license or certification
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Issuance
The Committee must issue a license by endorsement within 30 days after the application is filed and completed.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Prior license
Hold a license or certification to practice respiratory care in another state or a Canadian jurisdiction; present satisfactory evidence under IC 25-34.5-2-11(a)(1)(A). Any other jurisdiction’s own examination is an applicant condition, not an Indiana exam leaf.
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Initial licensure by examination
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Military spouse or dependent licensure based on an equivalent existing license
No examination is required for this applicant pathway.
Competence
Demonstrate occupational competency through methods determined by the Board; no particular licensing examination is identified in this route’s controlling requirements.
Conduct
Good standing, no discipline, no act warranting refusal, suspension, or revocation, and no pending professional-conduct or crime complaint or investigation. Pay Board fees.
Prior license
Hold for at least one year a current license, certificate, registration, or permit from another jurisdiction with substantially equivalent or greater requirements.
Status
Applicant must be a military spouse or dependent as defined by IC 25-1-17-1.5 and -3.
Statutory authority
IC 25-1-17-5 directs issuance notwithstanding any other law on its specified conditions.

Official no-examination sources

Effective from 2026-09-22.

Military service licensure based on an equivalent existing license
No examination is required for this applicant pathway.
Conduct
No act warranting refusal, suspension, or revocation and no pending professional-conduct or crime investigation or complaint; pay Board fees.
Prior license
Hold a current license, certification, registration, or permit from another jurisdiction with substantially equivalent or greater requirements, held for at least one year.
Status
Applicant must be a military service member as defined by IC 25-1-17-2.
Statutory authority
IC 25-1-17-4 directs issuance notwithstanding any other law; its specified issuance conditions do not prescribe a professional examination.

Official no-examination sources

Effective from 2026-09-22.

Renewal and continuing education extension following qualifying active military duty
No examination is required for this applicant pathway.
Active duty
Called to qualifying out-of-state active duty; the license was not revoked, suspended, lapsed, or subject to a complaint at entry; it expires during that duty and the expiration notice had not been received before entry.
Continuing education
Complete 15 hours in each biennium, averaging 7.5 annually, except the initial license issuance year; no more than 7.5 distance-learning or correspondence hours. Sign the renewal certification and retain CE records for four years under 844 IAC 11-5-4(b). The application page says three years; the rule is the controlling retention requirement.
Current cycle
The current biennium runs January 1, 2025 through December 31, 2026; 2025 initial licensees require 7.5 hours and 2026 initial licensees require no CE for this renewal.
Evidence
Provide discharge papers or government movement orders.
Existing license
Hold an Indiana respiratory care practitioner license.
Extension
The extension is 180 days after discharge or release, with a discretionary extension for service-related illness, injury, or disability up to 365 days. Late fees under this military renewal provision are waived.
Renewal
Renew biennially and pay the Board’s $50 renewal fee; licenses expire December 31 in even-numbered years.

Official no-examination sources

Effective from 2026-09-22.

Military service licensure based on equivalent training and occupational experience
No examination is required for this applicant pathway.
Conduct
No act warranting refusal, suspension, or revocation and no pending professional-conduct or crime investigation or complaint; pay Board fees.
Equivalence
Complete military training, receive and perform in the military occupational specialty at a level substantially equivalent to or exceeding the Board’s academic or experience requirements. Relevant service experience must be credited and the Board considers the American Council on Education guide.
Status
Applicant must be a military service member as defined by IC 25-1-17-2.
Statutory authority
IC 25-1-17-4 directs issuance notwithstanding any other law; its specified issuance conditions do not prescribe a professional examination.

Official no-examination sources

Effective from 2026-09-22.

Military member, spouse, or dependent licensure based on work experience in an unlicensed occupation
No examination is required for this applicant pathway.
Conduct
No disqualifying act, good standing without discipline, no pending professional-conduct or crime complaint or investigation; pay Board fees.
Experience
Work at least three years in a jurisdiction that does not license this lawful occupation; the Board must determine a similar scope of practice to the occupation requiring an Indiana license. Credit relevant full-time or part-time paid or volunteer experience under IC 25-1-17-6.
Status
Applicant is a military member, military spouse, or dependent.
Statutory authority
IC 25-1-17-5.5 directs issuance notwithstanding any other law on its specified conditions.

Official no-examination sources

Effective from 2026-09-22.

Licensure by national respiratory care credentials
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Board reexamination policy
The Board’s Respiratory Care Application by Credentials page states: "If five (5) years have elapsed since the successful completion of the National Board for Respiratory Care (NBRC) examination, the applicant must retake and successfully complete a current entry level NBRC examination within six (6) months of the date of application for licensure."
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
National credentials
Present credentials issued by a Committee-approved national respiratory care practitioner organization under IC 25-34.5-2-11(a)(1)(B). The Board lists this application as licensure by credentials.
Nonlicensing jurisdiction
An applicant endorsing from a jurisdiction that does not license, register, or certify respiratory care must submit a signed and dated statement that it does not regulate that practice.
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
New licensure after the statutory post revocation waiting period
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Revocation
A revoked license cannot be reinstated under IC 25-1-9-12. A new-license application cannot be made until seven years after revocation; the applicant is subject to the current ordinary qualifications and the Board’s disciplinary review.
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Reinstatement of a license delinquent more than three years, including discretionary competence re examination
Therapist Multiple-Choice Examination
Board submission
The Board requests $100 total fees, CE certificates covering 15 hours for the missed renewal and 7.5 hours per expired year, the CE Tracking Sheet, work history or resume, verification of other licenses, and any Board-required personal appearance, remediation, or training.
Discretion
IC 25-34.5-2-10(c) permits a competence examination. The Reinstatement of Expired License page states: "The Committee may require you to retake and pass the current entry level National Board for Respiratory Care (NBRC) examination with proof of the current examination results submitted to the Committee." It also permits requesting the most recent NBRC credential report. The current entry-level examination is the supplied TMC; the Board’s discretion and credential-report option do not remove that examination dependency.
Documents
Submit the completed renewal application, current renewal fee, reinstatement fee, and a sworn CE-compliance statement or satisfy the CE noncompliance provisions.
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Lapsed license
Hold a delinquent or lapsed Indiana respiratory care license that was not revoked or suspended.
Remediation
Complete Board-appropriate remediation, additional training, and other nonfee statutory or rule requirements under IC 25-1-8-6(d).
Review
IC 25-1-8-8 allows a reinstatement investigation, notice and personal appearance, with action within 120 days; the Board may impose probation by agreement.
Time
The license is more than three years delinquent.
Reinstatement of a license surrendered with Board approval
No examination is required for this applicant pathway.
Board conditions
IC 25-1-9-14 authorizes the Board to impose conditions appropriate to surrender or reinstatement; the provision specifies no professional licensing examination.
Surrender
The original surrender requires the Board’s written approval.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement following disciplinary suspension
No examination is required for this applicant pathway.
Corrective measures
The Board may impose disciplinary or corrective measures authorized in IC 25-1-9; these applicant-specific conditions do not identify a professional licensing examination.
Hearing
After a hearing the Board must be satisfied that the applicant can practice with reasonable skill and safety to the public.
Physical or mental assessment
The Board may order a reasonable physical or mental examination at the practitioner’s expense when capacity to practice safely is at issue in a disciplinary proceeding; this is a fitness condition, not a respiratory care licensing examination.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement of a license delinquent three years or less
No examination is required for this applicant pathway.
Documents
Submit the completed renewal application, current renewal fee, reinstatement fee, and a sworn CE-compliance statement or satisfy the CE noncompliance provisions.
Lapsed license
Hold a delinquent or lapsed Indiana respiratory care license that was not revoked or suspended.
Review
IC 25-1-8-8 allows a reinstatement investigation, notice and personal appearance, with action within 120 days; the Board may impose probation by agreement.
Time
IC 25-1-8-6(c) applies when the license is three years or less delinquent. The Board page instructs online renewal for less than three years and reinstatement submission at three years or more; the statute governs the examination boundary.

Official no-examination sources

Effective from 2026-09-22.

Restoration of unrestricted practice after probationary limitations
No examination is required for this applicant pathway.
Disciplinary probation
For disciplinary probation, the Board may withdraw or modify probation after a hearing if the deficiency has been remedied or changed circumstances warrant modification (IC 25-1-9-9(b)).
Hearing
For initial probationary licensure, the Board removes limitations after finding at a hearing that the deficiency has been remedied (IC 25-1-9-16(d)).

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal
No examination is required for this applicant pathway.
Continuing education
Complete 15 hours in each biennium, averaging 7.5 annually, except the initial license issuance year; no more than 7.5 distance-learning or correspondence hours. Sign the renewal certification and retain CE records for four years under 844 IAC 11-5-4(b). The application page says three years; the rule is the controlling retention requirement.
Current cycle
The current biennium runs January 1, 2025 through December 31, 2026; 2025 initial licensees require 7.5 hours and 2026 initial licensees require no CE for this renewal.
Existing license
Hold an Indiana respiratory care practitioner license.
Renewal
Renew biennially and pay the Board’s $50 renewal fee; licenses expire December 31 in even-numbered years.

Official no-examination sources

Effective from 2026-09-22.

Probationary Respiratory Care Practitioner License

Board-imposed probation and practice limitations under IC 25-1-9-9 or -16; not a separate professional specialty.

Licensing authority: Indiana Respiratory Care Committee / Medical Licensing Board of Indiana · Application information

Placement of an existing respiratory care license on disciplinary probation
No examination is required for this applicant pathway.
Existing license
Hold a respiratory care practitioner license and be subject to disciplinary sanctions.
Modification
The Board may modify or withdraw probation after a hearing under IC 25-1-9-9(b).
Probation
The Board may require reports, limit practice, direct education under a preceptor, or require or prohibit acts including community restitution or uncompensated service.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement or national credentials subject to Board imposed probation
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Board discretion
The applicant has prior discipline or an act that could have led to discipline bearing directly on competent practice, or practiced without a license. The Board may deny licensure or grant a probationary license.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Issuance
The Committee must issue a license by endorsement within 30 days after the application is filed and completed.
Limitations
The Board may require reporting, limited practice, continuing education, community restitution, or other acts appropriate for the public interest or applicant rehabilitation.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Prior license
Hold a license or certification to practice respiratory care in another state or a Canadian jurisdiction; present satisfactory evidence under IC 25-34.5-2-11(a)(1)(A). Any other jurisdiction’s own examination is an applicant condition, not an Indiana exam leaf.
Prior qualification
Hold a qualifying respiratory care license or certification or Committee-approved national respiratory care credentials under IC 25-34.5-2-11(a)(1).
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Initial licensure by examination subject to Board imposed probation
Application completion
The application page states that an application with requirements unsubmitted for one year is abandoned and a later application is treated as new.
Application fee
Submit the application and $50 nonrefundable fee; online processing fees apply.
Background check
Complete the national criminal history background check required by IC 25-0.5-1-21 and IC 25-1-1.1-4.
Board discretion
The applicant has prior discipline or an act that could have led to discipline bearing directly on competent practice, or practiced without a license. The Board may deny licensure or grant a probationary license.
Documents
The Board requires an official transcript, an NBRC credential report sent directly by NBRC (a certificate or score report copy is not accepted), direct verification of other health-profession licenses, name-change documents when applicable, and explanations and court records for positive application answers.
Education
Submit proof of graduation from a Board-standard respiratory care program, completion of United States military training in respiratory care, or sufficient postsecondary education for credentials from a Committee-approved national respiratory care organization (IC 25-34.5-2-8(b)).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Limitations
The Board may require reporting, limited practice, continuing education, community restitution, or other acts appropriate for the public interest or applicant rehabilitation.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Professional character
Provide satisfactory evidence concerning the convictions and unsafe-practice disciplinary actions specified in IC 25-34.5-2-8(a)(1)-(2).
Social security number
The application page requires disclosure of the applicant’s United States Social Security number and states that failure to provide it prevents processing.
Reinstatement with probation by agreement following investigation
Therapist Multiple-Choice Examination
Agreement
Following a personal appearance and by agreement between the applicant and Board, reinstate and place the applicant on probation under IC 25-1-9-9.
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Investigation
A reinstatement investigation under IC 25-1-8-8 may delay restoration up to 120 days.
Underlying restoration
Meet the applicable reinstatement conditions. For a license more than three years delinquent the Committee may require the current entry-level NBRC examination described in its reinstatement instructions; prior fulfillment or a waiver is an applicant condition.
Biennial renewal of a probationary respiratory care license
No examination is required for this applicant pathway.
Continuing education
Complete 15 hours in each biennium, averaging 7.5 annually, except the initial license issuance year; no more than 7.5 distance-learning or correspondence hours. Sign the renewal certification and retain CE records for four years under 844 IAC 11-5-4(b). The application page says three years; the rule is the controlling retention requirement.
Current cycle
The current biennium runs January 1, 2025 through December 31, 2026; 2025 initial licensees require 7.5 hours and 2026 initial licensees require no CE for this renewal.
Existing license
Hold an Indiana respiratory care practitioner license.
Probation
Continue to comply with the Board’s reporting, practice restrictions, education and other probation conditions until modified or removed.
Renewal
Renew biennially and pay the Board’s $50 renewal fee; licenses expire December 31 in even-numbered years.

Official no-examination sources

Effective from 2026-09-22.

Respiratory Care Temporary Permit

Temporary permission under IC 25-34.5-2-10.1; graduate, out-of-state license, and national-credential pathways have different conditions.

Licensing authority: Indiana Respiratory Care Committee / Medical Licensing Board of Indiana · Application information

Temporary permit by examination for an approved respiratory care graduate
Application
Submit the permit application and $25 fee. The statute directs issuance within 30 days after the application is filed and completed.
Duration
IC 25-34.5-2-10.1(b) ends the permit on full licensure or disapproval of the license application; 844 IAC 11-3-4.1 also sets expiration six months after graduation.
Education
Be qualified to take the licensing examination by graduating from a Board-standard respiratory care school or program; submit an original completion letter or certificate signed and sealed by the dean, or an official transcript. A transcript is required before the full license is issued.
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Examination timing
844 IAC 11-3-4.1 requires taking the licensure examination within six months after graduation and prohibits issue or renewal after a failed examination.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Temporary permit for an applicant holding a valid license or certificate elsewhere
No examination is required for this applicant pathway.
Duration
The statute ends the permit on full licensure or disapproval of the license application. The Temporary Permit Application page additionally states: "A temporary permit issued to an Endorsement applicant will be valid for a period of six (6) months from the date of issuance."
Fee
Pay the $25 temporary-permit application fee.
Prior license
Hold a valid license or certificate to practice respiratory care from another state and apply for the Indiana full license.
Scope
The permit itself is issued on the valid-license and application conditions in IC 25-34.5-2-10.1(a)(1), without an additional examination prerequisite; the full-license endorsement route separately records its section 8 examinations.
Verification
Submit the verification of current license, registration, or certification directly from the licensing authority.

Official no-examination sources

Effective from 2026-09-22.

Temporary permit for a nationally credentialed practitioner from an unlicensed jurisdiction
Duration
The statute ends the permit on full licensure or disapproval of the license application; the Board’s endorsement permit instructions also state a six-month period after issuance.
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Fee
Pay the $25 temporary-permit application fee.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.
Prior credential
Practice respiratory care in a jurisdiction that does not license or certify respiratory care practitioners and hold credentials from a Committee-approved national respiratory care practitioner association. Apply for the Indiana full license.
Proof
Submit a signed and dated statement that the originating jurisdiction does not license, register, or certify respiratory care and an NBRC credential report sent directly by NBRC.
Discretionary renewal of a temporary permit after a missed scheduled examination
Duration
A renewed temporary permit expires when the holder receives results of the examination given after permit issuance, under IC 25-34.5-2-10.1(d).
Evaluation date
This route describes examinations currently offered on September 22, 2026. The Board announcement identifies the new RT Examination as beginning January 1, 2027; that future examination is not a current requirement leaf. IC 25-34.5-2-8(a)(3)(B) applies only after December 31, 2027.
Failed examination
844 IAC 11-3-4.1 prohibits issuance or renewal of a graduate examination permit for an applicant who failed the examination.
Fee
The Board’s Temporary Permit Application instructions specify a $10 renewal fee.
Missed examination
The holder was scheduled to take the licensing examination, did not take it, and shows good cause in writing. The Committee decides renewal case by case.
National credential alternative
The approved NBRC credential may be supported by the TMC entry-level pathway or the TMC-plus-CSE registry pathway. CSE is part of the registry alternative, not an additional examination imposed on every applicant. Prior successful completion of a currently offered examination remains an examination dependency.

Clinical Simulation Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based clinical simulation examination of patient-management problems with information-gathering and decision-making sections; each section of each problem is classified to a minor content heading of the Detailed Content Outline. Admission requires the CRT and a TMC pass at the high cut score; with the implementation of the Respiratory Therapy Examination the CSE is available only to those who passed the TMC at the high cut score by December 31, 2026, and it ends December 31, 2027
Exam questions
22 problems: 20 scored and 2 pretest
Time limit
4 hours
Passing score
Points associated with the candidate’s set of responses are summed across the whole examination into one score compared with a cut score linked to examination committee decisions on whether each positively-scored option is required as a demonstration of minimal competence
Exam fee
$200 for both new and repeat applicants
Examination outline
  • I. PATIENT DATA
    • I.A. Evaluate Data in the Patient Record — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, Apgar scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, Apgar score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary exercise testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary exercise testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF EQUIPMENT, AND INFECTION CONTROL
    • II.A. Assemble /Troubleshoot Devices — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation device; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care Techniques in High-Risk Situations — 1. Emergency a. cardiopulmonary emergencies excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, EBUS, navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources

Therapist Multiple-Choice Examination

Provider
The National Board for Respiratory Care (NBRC); administered Monday through Saturday at more than 300 assessment centers through the NBRC testing agency PSI
Format
Computer-based multiple-choice examination; each scored item is linked to a content area and cognitive level (recall, application, analysis); the TMC ends December 31, 2026 and the Respiratory Therapy Examination is used from January 1, 2027
Exam questions
160 multiple-choice items: 140 scored and 20 pretest
Time limit
3 hours
Passing score
Raw score (each item worth one point) compared with two cut scores: the low cut score earns the CRT credential; the high cut score earns the CRT credential and eligibility for the Clinical Simulation Examination for candidates eligible to earn the RRT
Exam fee
$190 new applicants; $150 repeat applicants
Examination outline
  • I. PATIENT DATA (50 of 140 scored items; Recall 15, Application 27, Analysis 8) (35.71%)
    • I.A. Evaluate Data in the Patient Record (10 of 50 section items; Recall 4, Application 6, Analysis 0) — 1. Patient history, for example, history of present illness (HPI), orders, medication reconciliation, progress notes, DNR status / advance directives, social, family, and medical history; 2. Physical examination relative to the cardiopulmonary system; 3. Lines, drains, and airways, for example, chest tube, vascular lines, artificial airway; 4. Laboratory results, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 5. Blood gas analysis and / or hemoximetry (CO-oximetry) results; 6. Pulmonary function testing results, for example spirometry, lung volumes, DLCO; 7. 6-minute walk test results; 8. Imaging study results, for example, chest radiograph, CT scan, ultrasonography and / or echocardiography, PET scan, ventilation / perfusion scan; 9. Maternal and perinatal / neonatal history, for example, APGAR scores, gestational age, L / S ratio; 10. Sleep study results, for example, apnea-hypopnea index (AHI); 11. Trends in monitoring results: a. fluid balance; b. vital signs; c. intracranial pressure; d. ventilator liberation parameters; e. pulmonary mechanics; f. noninvasive, for example, pulse oximetry, capnography, transcutaneous; g. cardiac evaluation / monitoring results, for example, ECG, hemodynamic parameters; 12. Determination of a patient's pathophysiological state
    • I.B. Perform Clinical Assessment (10 of 50 section items; Recall 3, Application 6, Analysis 1) — 1. Interviewing a patient to assess a. level of consciousness and orientation, emotional state, and ability to cooperate; b. level of pain; c. shortness of breath, sputum production, and exercise tolerance; d. smoking history; e. environmental exposures; f. activities of daily living; g. learning needs, for example, literacy, preferred learning style, social / cultural; 2. Performing inspection to assess a. general appearance; b. characteristics of the airway, for example, patency, Mallampati classification, tracheal shift; c. cough, sputum amount and character; d. status of a neonate, for example, APGAR score, gestational age; e. skin integrity, for example, pressure ulcers, stoma site; 3. Palpating to assess a. pulse, rhythm, intensity; b. accessory muscle activity; c. asymmetrical chest movements, tactile fremitus, crepitus, tenderness, tactile rhonchi, and / or tracheal deviation; 4. Performing diagnostic chest percussion; 5. Auscultating to assess a. breath sounds; b. heart sounds and rhythm; c. blood pressure; 6. Reviewing a chest radiograph to assess a. quality of imaging, for example, patient positioning, penetration, lung inflation; b. presence and position of airways, lines, and drains; c. presence of foreign bodies; d. heart size and position; e. presence of, or change in, (i) cardiopulmonary abnormalities, for example, pneumothorax, consolidation, pleural effusion, pulmonary edema, pulmonary artery size; (ii) diaphragm, mediastinum, and / or trachea
    • I.C. Perform Procedures to Gather Clinical Information (12 of 50 section items; Recall 4, Application 7, Analysis 1) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas sample collection; 6. Blood gas analysis and / or hemoximetry (CO-oximetry); 7. Oxygen titration with exercise; 8. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 9. Hemodynamic monitoring; 10. Pulmonary compliance and airways resistance; 11. Plateau pressure; 12. Auto-PEEP determination; 13. Spontaneous breathing trial (SBT); 14. Apnea monitoring; 15. Apnea test (brain death determination); 16. Overnight pulse oximetry; 17. CPAP / NPPV titration during sleep; 18. Cuff management, for example, tracheal, laryngeal; 19. Sputum induction; 20. Cardiopulmonary stress testing; 21. 6-minute walk test; 22. Spirometry outside or inside a pulmonary function laboratory; 23. DLCO inside a pulmonary function laboratory; 24. Lung volumes inside a pulmonary function laboratory; 25. Tests of respiratory muscle strength - MIP and MEP; 26. Therapeutic bronchoscopy
    • I.D. Evaluate Procedure Results (10 of 50 section items; Recall 2, Application 4, Analysis 4) — 1. 12-lead ECG; 2. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 3. Peak flow; 4. Mechanics of spontaneous ventilation linked to tidal volume, minute volume, maximal inspiratory pressure, and vital capacity; 5. Blood gas analysis and / or hemoximetry (CO-oximetry); 6. Oxygen titration with exercise; 7. Cardiopulmonary calculations, for example, P(A-a)O2, VD / VT, P/F, OI; 8. Hemodynamic monitoring; 9. Pulmonary compliance and airways resistance; 10. Plateau pressure; 11. Auto-PEEP; 12. Spontaneous breathing trial (SBT); 13. Apnea monitoring; 14. Apnea test (brain death determination); 15. Overnight pulse oximetry; 16. CPAP / NPPV titration during sleep; 17. Cuff status, for example, laryngeal, tracheal; 18. Cardiopulmonary stress testing; 19. 6-minute walk test; 20. Spirometry outside or inside a pulmonary function laboratory; 21. DLCO inside a pulmonary function laboratory; 22. Lung volumes inside a pulmonary function laboratory; 23. Tests of respiratory muscle strength - MIP and MEP
    • I.E. Recommend Diagnostic Procedures (8 of 50 section items; Recall 2, Application 4, Analysis 2) — 1. Testing for tuberculosis; 2. Laboratory tests, for example, CBC, electrolytes, coagulation studies, sputum culture and sensitivities, cardiac biomarkers; 3. Imaging studies; 4. Bronchoscopy a. diagnostic; b. therapeutic; 5. Bronchoalveolar lavage (BAL); 6. Pulmonary function testing; 7. Noninvasive monitoring, for example, pulse oximetry, capnography, transcutaneous; 8. Blood gas and/or hemoximetry (CO-oximetry); 9. ECG; 10. Exhaled gas analysis, for example, CO2, CO, FENO; 11. Hemodynamic monitoring; 12. Sleep studies; 13. Thoracentesis
  • II. TROUBLESHOOTING AND QUALITY CONTROL OF DEVICES, AND INFECTION CONTROL (20 of 140 scored items; Recall 8, Application 9, Analysis 3) (14.29%)
    • II.A. Assemble / Troubleshoot Devices (15 of 20 section items; Recall 4, Application 8, Analysis 3) — 1. Medical gas delivery interfaces, for example, mask, cannula, heated high-flow nasal cannula; 2. Long-term oxygen therapy; 3. Medical gas delivery, metering, and /or clinical analyzing devices, for example, concentrator, liquid system, flowmeter, regulator, gas cylinder, blender, air compressor, gas analyzers; 4. CPAP / NPPV with patient interfaces; 5. Humidifiers; 6. Nebulizers; 7. Metered-dose inhalers, spacers, and valved holding chambers; 8. Dry-powder inhalers (DPI); 9. Resuscitation equipment, for example, self-inflating resuscitator, flow-inflating resuscitator, AED; 10. Mechanical ventilators; 11. Intubation equipment; 12. Artificial airways; 13. Suctioning equipment, for example, regulator, canister, tubing, catheter; 14. Blood analyzers, for example, hemoximetry (CO-oximetry), point-of-care, blood gas; 15. Patient breathing circuits; 16. Hyperinflation devices; 17. Secretion clearance devices; 18. Heliox delivery device; 19. Portable spirometer; 20. Testing equipment in a pulmonary function laboratory; 21. Pleural drainage; 22. Noninvasive monitoring, for example, pulse oximeter, capnometer, transcutaneous; 23. Bronchoscopes and light sources; 24. Hemodynamic monitoring a. pressure transducers; b. catheters, for example, arterial, pulmonary artery
    • II.B. Ensure Infection Prevention (2 of 20 section items; Recall 2, Application 0, Analysis 0) — 1. Adhering to infection prevention policies and procedures, for example, Standard Precautions, donning/doffing, isolation; 2. Adhering to disinfection policies and procedures; 3. Proper handling of biohazardous materials
    • II.C. Perform Quality Control Procedures (3 of 20 section items; Recall 2, Application 1, Analysis 0) — 1. Blood analyzers; 2. Gas analyzers; 3. Pulmonary function equipment for testing a. spirometry results; b. lung volumes; c. diffusing capacity (DLCO); 4. Mechanical ventilators; 5. Noninvasive monitors
  • III. INITIATION AND MODIFICATION OF INTERVENTIONS (70 of 140 scored items; Recall 10, Application 30, Analysis 30) (50%)
    • III.A. Maintain a Patent Airway Including the Care of Artificial Airways (10 of 70 section items; Recall 3, Application 4, Analysis 3) — 1. Proper positioning of a patient; 2. Recognition of a difficult airway; 3. Establishing and managing a patient's airway a. nasopharyngeal airway; b. oropharyngeal airway; c. esophagealtracheal tubes / supraglottic airways; d. endotracheal tube; e. tracheostomy tube; f. laryngectomy tube; g. speaking valves; h. devices that assist with intubation, for example, endotracheal tube exchanger, video laryngoscopy; 4. Performing tracheostomy care; 5. Exchanging artificial airways; 6. Maintaining adequate humidification; 7. Initiating protocols to prevent ventilator-associated infections; 8. Performing extubation
    • III.B. Perform Airway Clearance and Lung Expansion Techniques (5 of 70 section items; Recall 2, Application 2, Analysis 1) — 1. Postural drainage, percussion, or vibration; 2. Suctioning, for example, nasotracheal, oropharyngeal; 3. Mechanical devices, for example, high-frequency chest wall oscillation, vibratory PEP, intrapulmonary percussive ventilation, insufflation / exsufflation; 4. Assisted cough, for example, huff, abdominal thrust; 5. Hyperinflation therapy; 6. Inspiratory muscle training
    • III.C. Support Oxygenation and Ventilation (15 of 70 section items; Recall 1, Application 5, Analysis 9) — 1. Initiating and adjusting oxygen therapy; 2. Minimizing hypoxemia, for example, patient positioning, secretion removal; 3. Initiating and adjusting mask or nasal CPAP; 4. Initiating and adjusting mechanical ventilation settings a. continuous mechanical ventilation; b. noninvasive ventilation; c. high-frequency ventilation; d. alarms; 5. Recognizing and correcting patient-ventilator dyssynchrony; 6. Utilizing ventilator graphics; 7. Performing lung recruitment maneuvers; 8. Liberating a patient from mechanical ventilation
    • III.D. Administer Medications and Specialty Gases (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Aerosolized preparations a. antimicrobials; b. pulmonary vasodilators; c. bronchodilators; d. mucolytics / proteolytics; e. steroids; 2. Endotracheal instillation; 3. Specialty gases, for example, heliox, inhaled NO
    • III.E. Ensure Modifications are Made to the Respiratory Care Plan (18 of 70 section items; Recall 1, Application 7, Analysis 10) — 1. Treatment termination, for example, life-threatening adverse event; 2. Recommendations a. starting treatment based on patient response; b. treatment of pneumothorax; c. adjustment of fluid balance; d. adjustment of electrolyte therapy; e. insertion or change of artificial airway; f. liberating from mechanical ventilation; g. extubation; h. discontinuing treatment based on patient response; i. consultation from a physician specialist; 3. Recommendations for changes a. patient position; b. oxygen therapy; c. humidification; d. airway clearance; e. hyperinflation; f. mechanical ventilation; 4. Recommendations for pharmacologic interventions a. bronchodilators; b. anti-inflammatory drugs; c. mucolytics and proteolytics; d. aerosolized antibiotics; e. inhaled pulmonary vasodilators; f. cardiovascular; g. antimicrobials; h. sedatives and hypnotics; i. analgesics; j. narcotic antagonists; k. benzodiazepine antagonists; l. neuromuscular blocking agents; m. diuretics; n. surfactants; o. changes to drug, dosage, administration frequency, mode, or concentration
    • III.F. Utilize Evidence-Based Practice (6 of 70 section items; Recall 0, Application 2, Analysis 4) — 1. Classification of disease severity; 2. Recommendations for changes in a therapeutic plan when indicated; 3. Application of guidelines, for example, ARDSNet, NAEPP, GOLD
    • III.G. Provide Respiratory Care in High-Risk Situations (5 of 70 section items; Recall 0, Application 2, Analysis 3) — 1. Emergency a. cardiopulmonary emergencies, excluding CPR; b. disaster management; c. medical emergency team (MET) / rapid response team; 2. Interprofessional communication; 3. Patient transport a. land / air between hospitals; b. within a hospital
    • III.H. Assist a Physician / Provider in Performing Procedures (4 of 70 section items; Recall 1, Application 3, Analysis 0) — 1. Intubation; 2. Bronchoscopy; 3. Specialized bronchoscopy, for example, endobronchial ultrasound (EBUS), navigational bronchoscopy (ENB); 4. Thoracentesis; 5. Tracheotomy; 6. Chest tube insertion; 7. Insertion of arterial or venous catheters; 8. Moderate (conscious) sedation; 9. Cardioversion; 10. Withdrawal of life support
    • III.I. Conduct Patient and Family Education (3 of 70 section items; Recall 1, Application 2, Analysis 0) — 1. Safety and infection control; 2. Home care and related equipment; 3. Lifestyle changes, for example, smoking cessation, exercise; 4. Pulmonary rehabilitation; 5. Disease / condition management, for example, asthma, COPD, CF, tracheostomy care, ventilator dependent
Examination sources