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Iowa Respiratory Therapy — Requirements & Free Practice

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Respiratory Care and Polysomnography Practitioner

Iowa dual license authorizing respiratory care and polysomnography practice.

Licensing authority: Iowa Board of Respiratory Care and Polysomnography · Application information

Conversion from respiratory care practitioner licensure at renewal
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Existing License
Hold an Iowa respiratory care practitioner license and request the dual license with the renewal application under §148G.6(1). Prior passage of a currently offered TMC remains a leaf even if it predates this application.
Polysomnography Qualification
Also satisfy one of the polysomnography qualifications in 481—720.5(2): accredited polysomnographic education, accredited sleep specialist program plus listed verification, accredited electroneurodiagnostic polysomnography track, or another active Iowa professional license with employer medical-director training and competence verification.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Foreign trained dual licensure
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Board Determination
Obtain the Board’s final determination on the application.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Diploma
Provide a copy of the foreign respiratory care certificate or diploma.
Education Evaluation
At the applicant’s expense, obtain an equivalency evaluation from International Education Research Foundation, Inc., Credentials Evaluation Service, or International Credentialing Associates, Inc.; the professional curriculum must be equivalent to the rules.
Polysomnography Qualification
Also satisfy one of the polysomnography qualifications in 481—720.5(2): accredited polysomnographic education, accredited sleep specialist program plus listed verification, accredited electroneurodiagnostic polysomnography track, or another active Iowa professional license with employer medical-director training and competence verification.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Initial dual licensure — electroneurodiagnostic program
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Polysomnography Qualification
Graduate from a CAAHEP-accredited electroneurodiagnostic technologist program with a polysomnographic track and direct institution transcript. Iowa Code §148G.6(1)(c) also specifies an accredited polysomnographic certificate extension or Board-equivalent program.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Initial dual licensure — existing professional license
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Polysomnography Qualification
Hold another active Iowa professional license under §147.2 in good standing and obtain employer medical-director or designee verification of on-the-job polysomnography training and competence.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Initial dual licensure — polysomnography program
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Polysomnography Qualification
Graduate from a CAAHEP-accredited polysomnographic education program and have the institution send the transcript directly.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Initial dual licensure — sleep specialist program
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Polysomnography Qualification
Complete a CoARC- or CAAHEP-accredited sleep specialist program option with direct transcript and direct-source verification of a CAAHEP polysomnographic certificate extension, NBRC sleep disorder specialist credential, or BRPT registered polysomnographic technologist credential.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Dual licensure with military education or experience credit
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Military Credit
Apply for credit for verified military education, training or service toward educational or experience requirements. Identify the requirement and supply military transcripts, affidavit, DD214, VMET or other verification. The licensing authority decides the credit before acting on licensure; examination credit is not granted under 481—7.2.
Polysomnography Qualification
Also satisfy one of the polysomnography qualifications in 481—720.5(2): accredited polysomnographic education, accredited sleep specialist program plus listed verification, accredited electroneurodiagnostic polysomnography track, or another active Iowa professional license with employer medical-director training and competence verification.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Expedited substantially similar scope veteran or military spouse reciprocity
No examination is required for this applicant pathway.
Board Rule Demand
481—7.3(1) states: 7.3(1) A veteran or spouse with an unrestricted professional license in another jurisdiction may apply for licensure in Iowa through reciprocity in accordance with Iowa Code chapter 272C. A veteran or spouse must pass any examinations required for licensure to be eligible for licensure through reciprocity and will be given credit for examinations previously passed when consistent with the licensing authority’s laws and rules on examination requirements. A fully completed application for licensure submitted by a veteran or spouse under this subrule will be given priority and will be expedited. The explicit statutory no-examination issuance in §272C.12 controls this substantially similar-scope route; the rule’s additional examination demand is retained here as an applicant condition.
Compact Restriction
A compact privilege holder cannot use verification under 481—501.1(5); the verification license itself grants no interstate compact eligibility.
Criminal History
No disqualifying criminal history; supply the full criminal record and relevant disciplinary documents if applicable.
Discipline
No revoked license or voluntary surrender while under investigation. Resolved prior discipline requires Board review; unresolved discipline or pending professional complaints, allegations or investigations prevents issuance or denial until resolved.
Examination Reading
Section 272C.12 expressly provides issuance without an examination. The unnamed prior examination of the issuing jurisdiction is an applicant condition; no specific currently offered examination is identified for this verification route.
Fees And Documents
Pay applicable fees, submit application, attestation of §272C.12 compliance, written scope statement and relevant scope-of-practice laws. Supply fingerprint cards and signed waiver if required.
Military Status
Verify veteran status under Iowa Code §35.1(2), or marriage to an active-duty military member, and submit the ordinary reciprocity application documentation. The application receives priority and expedited review.
Original Qualifications
The issuing jurisdiction imposed and verifies its minimum educational and, if applicable, experience and clinical-supervision qualifications.
Other License
Hold an active license in another issuing jurisdiction with substantially similar scope; it must be in good standing in every issuing jurisdiction.
Prior Examination
Previously pass the examination required by the issuing jurisdiction, if applicable, under §272C.12(1)(d). This passage does not identify a particular examination; another jurisdiction’s own examination is a condition.

Official no-examination sources

Effective from 2026-09-22.

Full licensure after completing temporary military license training
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Duration
The full-license application remains pending until training is completed or the temporary license expires. Extensions require good cause and case-by-case approval.
Military Status
Be a veteran or active-duty military spouse licensed elsewhere whose practice scope is not substantially equivalent to Iowa’s.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Prior Passing Requirement
481—7.3(5)(a) prohibits temporary issuance until the required licensing examinations have been passed. Those current examinations remain route requirements even when passed before applying.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Training Completion
Submit records showing completion of the education or training specified by the licensing authority under §272C.12A(2). Section 272C.12A(3) then directs full-license issuance. Required examination passage already established before temporary issuance remains a current-examination leaf.
Training Deficiency
Complete the additional education or training the authority identifies. The temporary license is for a specified period and may be conditioned to protect public health, welfare and safety; the authority may deny it if the deficiency adversely affects the public.
Reactivation after five or less inactive years
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Current Competence
Within the preceding 24 months, provide 24 hours of conforming continuing education including 8 to 12 hours on sleep-related topics, or verification of at least 2,080 hours of active practice in another jurisdiction in the preceding 24 months.
Inactive Period
Inactive for five years or less.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Reactivation after more than five inactive years
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Current Competence
Within the preceding 24 months, provide 48 hours of conforming continuing education including 16 to 24 hours on sleep-related topics, or verification of at least 2,080 hours of active practice in another jurisdiction in the preceding 24 months.
Inactive Period
Inactive for more than five years.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement following revocation, suspension or voluntary surrender
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Board Order
Meet the terms and conditions of the revocation or suspension order. If no terms were established, or the license was surrendered, wait at least one year unless law provides otherwise. Apply in the original contested case and prove the original basis no longer exists and reinstatement serves the public interest. Any individual order conditions remain applicant conditions.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Prior Discipline
The license was revoked, suspended or voluntarily surrendered. A permanently revoked license cannot be reinstated.
Published Cross References
481—720.8 prints references to 481—506.31 and 481—720.14. In the independently obtained current chapters, the provisions titled Reinstatement and License reactivation are 481—506.32 and 481—720.7; 506.31 concerns public records and no 720.14 text is present. The reinstatement and reactivation procedures are applied by their explicit titles and substance, with the published references preserved here.
Reactivation
Obtain reinstatement and reactivation before practicing; satisfy the applicable current-competence and other reactivation requirements of 481—720.7.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal through continuing education
No examination is required for this applicant pathway.
Application And Fee
Submit the completed renewal application and fee. Initial licenses issued within six months of renewal need not renew until the subsequent biennium.
Continuing Education
Complete at least 24 hours during the biennial compliance period. First-time licensees have no CE prerequisite for first renewal and may use initial-license-to-second-renewal credits. Up to fifty percent of excess prior-period hours may be carried forward. Qualifying military service and other statutory circumstances may satisfy CE under §272C.2(4).
Current License
Hold the license and apply for biennial renewal before expiration: April 1 of an even-numbered year through March 31 of the next even-numbered year.
Late Renewal
A 30-day grace period permits renewal with completed requirements and the late fee. Failure to renew by its end makes the license inactive.
Mandatory Reporting
When practice or employment includes examining, attending, counseling or treating children or dependent adults, complete the applicable Iowa HHS mandatory-reporter training; military or significant-hardship suspension may apply under 720.6(4).
Renewal Basis
Use continuing education under 481—720.6(3) and 721.2 rather than the examination substitute in Iowa Code §152B.11(1).

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal using the respiratory care licensing examination instead of continuing education

At least one of the following alternatives:

Application And Fee
Submit the completed renewal application and fee. Initial licenses issued within six months of renewal need not renew until the subsequent biennium.
Current License
Hold the license and apply for biennial renewal before expiration: April 1 of an even-numbered year through March 31 of the next even-numbered year.
Examination Substitution
Iowa Code §152B.11(1) permits successful completion of the most current respiratory care licensure examination instead of continuing education. The currently identified respiratory care licensing examination is TMC under 481—720.3(3). This route is available for the respiratory care authorization held by ordinary and dual licensees; it is not a fresh dual-license application.
Late Renewal
A 30-day grace period permits renewal with completed requirements and the late fee. Failure to renew by its end makes the license inactive.
Mandatory Reporting
When practice or employment includes examining, attending, counseling or treating children or dependent adults, complete the applicable Iowa HHS mandatory-reporter training; military or significant-hardship suspension may apply under 720.6(4).
Passing Standard
Meet or exceed the minimum NBRC passing score.
Licensure by verification of substantially similar out of state licensure
No examination is required for this applicant pathway.
Compact Restriction
A compact privilege holder cannot use verification under 481—501.1(5); the verification license itself grants no interstate compact eligibility.
Criminal History
No disqualifying criminal history; supply the full criminal record and relevant disciplinary documents if applicable.
Discipline
No revoked license or voluntary surrender while under investigation. Resolved prior discipline requires Board review; unresolved discipline or pending professional complaints, allegations or investigations prevents issuance or denial until resolved.
Examination Reading
Section 272C.12 expressly provides issuance without an examination. The unnamed prior examination of the issuing jurisdiction is an applicant condition; no specific currently offered examination is identified for this verification route.
Fees And Documents
Pay applicable fees, submit application, attestation of §272C.12 compliance, written scope statement and relevant scope-of-practice laws. Supply fingerprint cards and signed waiver if required.
Original Qualifications
The issuing jurisdiction imposed and verifies its minimum educational and, if applicable, experience and clinical-supervision qualifications.
Other License
Hold an active license in another issuing jurisdiction with substantially similar scope; it must be in good standing in every issuing jurisdiction.
Prior Examination
Previously pass the examination required by the issuing jurisdiction, if applicable, under §272C.12(1)(d). This passage does not identify a particular examination; another jurisdiction’s own examination is a condition.

Official no-examination sources

Effective from 2026-09-22.

Dual licensure with work experience replacing education and training
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Work Experience
Relocate to Iowa from a jurisdiction not requiring licensure; show Iowa residency and at least three years of substantially similar work experience within the four years preceding application. Board acceptance substitutes this experience for educational and training requirements under §272C.13 and 481—501.2; other requirements and examinations remain applicable.

Temporary Respiratory Care and Polysomnography Practitioner License

Temporary license for a veteran or active-duty military spouse completing required education or training.

Licensing authority: Iowa Board of Respiratory Care and Polysomnography · Application information

Temporary veteran or military spouse licensure while completing training
Age
Be at least eighteen years old under Iowa Code §148G.6(1).
Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Character
The application must demonstrate good moral character under §148G.6(1), subject to Iowa Code §272C.15 limitations on criminal-conviction disqualifications.
Duration
The full-license application remains pending until training is completed or the temporary license expires. Extensions require good cause and case-by-case approval.
Military Status
Be a veteran or active-duty military spouse licensed elsewhere whose practice scope is not substantially equivalent to Iowa’s.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Prior Passing Requirement
481—7.3(5)(a) prohibits temporary issuance until the required licensing examinations have been passed. Those current examinations remain route requirements even when passed before applying.
Score Documentation
Provide the examination evidence permitted by 481—720.5(1)(c). Its references to CRT/RRT certificates and the NBRC “State Clinical Examination” are documentation alternatives; the explicit required examinations are those named in 720.5(1)(b).
Specialty Examination
In addition to TMC, pass either the NBRC Sleep Disorders Specialist Examination (SDS), called Sleep Disorders Specialty Examination by its owner, or the BRPT Registered Polysomnographic Technologist Examination. Meet the applicable NBRC or BRPT minimum passing score. SDS is a currently offered respiratory care specialty but no SDS version is supplied in the frozen nationwide context; it remains a condition with a nationwide registration gap. BRPT’s examination is for the separate profession of polysomnographic technology and remains a condition under this contract.
Training Deficiency
Complete the additional education or training the authority identifies. The temporary license is for a specified period and may be conditioned to protect public health, welfare and safety; the authority may deny it if the deficiency adversely affects the public.

Respiratory Care Practitioner

Iowa license to practice respiratory care.

Licensing authority: Iowa Board of Respiratory Care and Polysomnography · Application information

Foreign trained initial licensure

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Board Determination
Obtain the Board’s final determination on the application.
Diploma
Provide a copy of the foreign respiratory care certificate or diploma.
Education Evaluation
At the applicant’s expense, obtain an equivalency evaluation from International Education Research Foundation, Inc., Credentials Evaluation Service, or International Credentialing Associates, Inc.; the professional curriculum must be equivalent to the rules.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Initial licensure by examination

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Initial licensure with military education or experience credit

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Education
Successfully complete a respiratory care education program accredited by, or under a letter of review from, CoARC or CAAHEP.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Military Credit
Apply for credit for verified military education, training or service toward educational or experience requirements. Identify the requirement and supply military transcripts, affidavit, DD214, VMET or other verification. The licensing authority decides the credit before acting on licensure; examination credit is not granted under 481—7.2.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Expedited substantially similar scope veteran or military spouse reciprocity
No examination is required for this applicant pathway.
Board Rule Demand
481—7.3(1) states: 7.3(1) A veteran or spouse with an unrestricted professional license in another jurisdiction may apply for licensure in Iowa through reciprocity in accordance with Iowa Code chapter 272C. A veteran or spouse must pass any examinations required for licensure to be eligible for licensure through reciprocity and will be given credit for examinations previously passed when consistent with the licensing authority’s laws and rules on examination requirements. A fully completed application for licensure submitted by a veteran or spouse under this subrule will be given priority and will be expedited. The explicit statutory no-examination issuance in §272C.12 controls this substantially similar-scope route; the rule’s additional examination demand is retained here as an applicant condition.
Compact Restriction
A compact privilege holder cannot use verification under 481—501.1(5); the verification license itself grants no interstate compact eligibility.
Criminal History
No disqualifying criminal history; supply the full criminal record and relevant disciplinary documents if applicable.
Discipline
No revoked license or voluntary surrender while under investigation. Resolved prior discipline requires Board review; unresolved discipline or pending professional complaints, allegations or investigations prevents issuance or denial until resolved.
Examination Reading
Section 272C.12 expressly provides issuance without an examination. The unnamed prior examination of the issuing jurisdiction is an applicant condition; no specific currently offered examination is identified for this verification route.
Fees And Documents
Pay applicable fees, submit application, attestation of §272C.12 compliance, written scope statement and relevant scope-of-practice laws. Supply fingerprint cards and signed waiver if required.
Military Status
Verify veteran status under Iowa Code §35.1(2), or marriage to an active-duty military member, and submit the ordinary reciprocity application documentation. The application receives priority and expedited review.
Original Qualifications
The issuing jurisdiction imposed and verifies its minimum educational and, if applicable, experience and clinical-supervision qualifications.
Other License
Hold an active license in another issuing jurisdiction with substantially similar scope; it must be in good standing in every issuing jurisdiction.
Prior Examination
Previously pass the examination required by the issuing jurisdiction, if applicable, under §272C.12(1)(d). This passage does not identify a particular examination; another jurisdiction’s own examination is a condition.

Official no-examination sources

Effective from 2026-09-22.

Full licensure after completing temporary military license training

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Duration
The full-license application remains pending until training is completed or the temporary license expires. Extensions require good cause and case-by-case approval.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Military Status
Be a veteran or active-duty military spouse licensed elsewhere whose practice scope is not substantially equivalent to Iowa’s.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Prior Passing Requirement
481—7.3(5)(a) prohibits temporary issuance until the required licensing examinations have been passed. Those current examinations remain route requirements even when passed before applying.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Training Completion
Submit records showing completion of the education or training specified by the licensing authority under §272C.12A(2). Section 272C.12A(3) then directs full-license issuance. Required examination passage already established before temporary issuance remains a current-examination leaf.
Training Deficiency
Complete the additional education or training the authority identifies. The temporary license is for a specified period and may be conditioned to protect public health, welfare and safety; the authority may deny it if the deficiency adversely affects the public.
Reactivation after five or less inactive years
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Current Competence
Within the preceding 24 months, provide 24 hours of conforming continuing education, or verification of at least 2,080 hours of active practice in another jurisdiction in the preceding 24 months.
Inactive Period
Inactive for five years or less.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Reactivation after more than five inactive years
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Current Competence
Within the preceding 24 months, provide 48 hours of conforming continuing education, or verification of at least 2,080 hours of active practice in another jurisdiction in the preceding 24 months.
Inactive Period
Inactive for more than five years.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement following revocation, suspension or voluntary surrender
No examination is required for this applicant pathway.
Application
Apply for reactivation and pay the reactivation fee. Inactive licensure does not authorize practice.
Background Check
After two or more inactive years, submit two completed fingerprint cards and pay DCI/FBI costs; issuance may await reports.
Board Order
Meet the terms and conditions of the revocation or suspension order. If no terms were established, or the license was surrendered, wait at least one year unless law provides otherwise. Apply in the original contested case and prove the original basis no longer exists and reinstatement serves the public interest. Any individual order conditions remain applicant conditions.
License Verification
Verify the jurisdiction in which most recently practicing while the Iowa license was inactive, including name, initial licensing date, status and discipline; disclose public or pending complaints.
Prior Discipline
The license was revoked, suspended or voluntarily surrendered. A permanently revoked license cannot be reinstated.
Published Cross References
481—720.8 prints references to 481—506.31 and 481—720.14. In the independently obtained current chapters, the provisions titled Reinstatement and License reactivation are 481—506.32 and 481—720.7; 506.31 concerns public records and no 720.14 text is present. The reinstatement and reactivation procedures are applied by their explicit titles and substance, with the published references preserved here.
Reactivation
Obtain reinstatement and reactivation before practicing; satisfy the applicable current-competence and other reactivation requirements of 481—720.7.
Recent Practice Statement
Submit an employer or professional-associate sworn statement identifying places and dates and at least 2,080 practice hours or equivalent full-time faculty teaching for one of the immediately preceding years in the last two years. Sole proprietors may attest on their own behalf.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal through continuing education
No examination is required for this applicant pathway.
Application And Fee
Submit the completed renewal application and fee. Initial licenses issued within six months of renewal need not renew until the subsequent biennium.
Continuing Education
Complete at least 24 hours during the biennial compliance period. First-time licensees have no CE prerequisite for first renewal and may use initial-license-to-second-renewal credits. Up to fifty percent of excess prior-period hours may be carried forward. Qualifying military service and other statutory circumstances may satisfy CE under §272C.2(4).
Current License
Hold the license and apply for biennial renewal before expiration: April 1 of an even-numbered year through March 31 of the next even-numbered year.
Late Renewal
A 30-day grace period permits renewal with completed requirements and the late fee. Failure to renew by its end makes the license inactive.
Mandatory Reporting
When practice or employment includes examining, attending, counseling or treating children or dependent adults, complete the applicable Iowa HHS mandatory-reporter training; military or significant-hardship suspension may apply under 720.6(4).
Renewal Basis
Use continuing education under 481—720.6(3) and 721.2 rather than the examination substitute in Iowa Code §152B.11(1).

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal using the respiratory care licensing examination instead of continuing education

At least one of the following alternatives:

Application And Fee
Submit the completed renewal application and fee. Initial licenses issued within six months of renewal need not renew until the subsequent biennium.
Current License
Hold the license and apply for biennial renewal before expiration: April 1 of an even-numbered year through March 31 of the next even-numbered year.
Examination Substitution
Iowa Code §152B.11(1) permits successful completion of the most current respiratory care licensure examination instead of continuing education. The currently identified respiratory care licensing examination is TMC under 481—720.3(3). This route is available for the respiratory care authorization held by ordinary and dual licensees; it is not a fresh dual-license application.
Late Renewal
A 30-day grace period permits renewal with completed requirements and the late fee. Failure to renew by its end makes the license inactive.
Mandatory Reporting
When practice or employment includes examining, attending, counseling or treating children or dependent adults, complete the applicable Iowa HHS mandatory-reporter training; military or significant-hardship suspension may apply under 720.6(4).
Passing Standard
Meet or exceed the minimum NBRC passing score.
Licensure by verification of substantially similar out of state licensure
No examination is required for this applicant pathway.
Compact Restriction
A compact privilege holder cannot use verification under 481—501.1(5); the verification license itself grants no interstate compact eligibility.
Criminal History
No disqualifying criminal history; supply the full criminal record and relevant disciplinary documents if applicable.
Discipline
No revoked license or voluntary surrender while under investigation. Resolved prior discipline requires Board review; unresolved discipline or pending professional complaints, allegations or investigations prevents issuance or denial until resolved.
Examination Reading
Section 272C.12 expressly provides issuance without an examination. The unnamed prior examination of the issuing jurisdiction is an applicant condition; no specific currently offered examination is identified for this verification route.
Fees And Documents
Pay applicable fees, submit application, attestation of §272C.12 compliance, written scope statement and relevant scope-of-practice laws. Supply fingerprint cards and signed waiver if required.
Original Qualifications
The issuing jurisdiction imposed and verifies its minimum educational and, if applicable, experience and clinical-supervision qualifications.
Other License
Hold an active license in another issuing jurisdiction with substantially similar scope; it must be in good standing in every issuing jurisdiction.
Prior Examination
Previously pass the examination required by the issuing jurisdiction, if applicable, under §272C.12(1)(d). This passage does not identify a particular examination; another jurisdiction’s own examination is a condition.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with work experience replacing education and training

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Work Experience
Relocate to Iowa from a jurisdiction not requiring licensure; show Iowa residency and at least three years of substantially similar work experience within the four years preceding application. Board acceptance substitutes this experience for educational and training requirements under §272C.13 and 481—501.2; other requirements and examinations remain applicable.

Temporary Respiratory Care Practitioner License

Temporary license for a veteran or active-duty military spouse completing required education or training.

Licensing authority: Iowa Board of Respiratory Care and Polysomnography · Application information

Temporary veteran or military spouse licensure while completing training

At least one of the following alternatives:

Application
Submit the online application and applicable fee. Incomplete applications remaining on file more than two years become invalid.
Background Check
Submit two completed sets of fingerprint cards and the release for DCI and FBI criminal history checks; pay the assessment costs. The Board may withhold issuance pending the reports.
Duration
The full-license application remains pending until training is completed or the temporary license expires. Extensions require good cause and case-by-case approval.
Legacy Examination
A previously earned CRT credential or score may document the former Certified Respiratory Therapist Examination. NBRC replaced that separate examination with the TMC in January 2015; that former examination is a condition, not a current leaf.
Military Status
Be a veteran or active-duty military spouse licensed elsewhere whose practice scope is not substantially equivalent to Iowa’s.
Passing Standard
Meet or exceed the minimum NBRC passing score.
Prior Licenses
When previously licensed, verify the most recent jurisdiction directly, or through a website showing name, initial issuance, status and disciplinary action; disclose public or pending complaints. The Board application page additionally asks for verification of all prior licenses.
Prior Passing Requirement
481—7.3(5)(a) prohibits temporary issuance until the required licensing examinations have been passed. Those current examinations remain route requirements even when passed before applying.
Score Documentation
Provide direct examination-service scores, CRT or RRT credential certificate, or score report or NBRC web confirmation under 481—720.3(4). CRT/RRT certificates are documentation alternatives. The specific examination requirement in 481—720.3(3) remains controlling; an RRT certificate does not add a separately required CSE to this route.
Training Deficiency
Complete the additional education or training the authority identifies. The temporary license is for a specified period and may be conditioned to protect public health, welfare and safety; the authority may deny it if the deficiency adversely affects the public.

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