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Michigan Respiratory Therapy — Requirements & Free Practice

US-MI · License preparation

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Respiratory Therapist

Ordinary license to practice respiratory care. The initial grandfather and temporary conversion provisions in MCL 333.18709(2)-(3) and 333.18711 were confined to the 2004 implementation period and cannot create a current application pathway in 2026.

Licensing authority: Michigan Department of Licensing and Regulatory Affairs / Michigan Board of Respiratory Care · Application information

Endorsement after at least five years of licensure Canadian province
No examination is required for this applicant pathway.
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Canadian Qualifications
Meet MCL 333.16186(1)(c)-(d): Canadian or United States educational requirements and Michigan service/billing location; an approved United States or Canadian national examination may establish licensing-standard equivalence under subsection (3). The unnamed examination option is an applicant condition. LARA must consult the NBRC-CSRT reciprocity agreement in effect July 1, 2004 under subsection (4).
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Licensing Equivalence
Meet the applicable substantially equivalent standards under MCL 333.16186; the Board may request an interview about qualifications. No NBRC examination or certification submission is imposed by R 338.2205(1), unlike subsection (2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Prior Licensure
An active license in good standing in a Canadian province immediately preceding application, held for at least five years.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.

Official no-examination sources

Effective from 2026-09-22.

Endorsement after at least five years of licensure United States state
No examination is required for this applicant pathway.
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Licensing Equivalence
Meet the applicable substantially equivalent standards under MCL 333.16186; the Board may request an interview about qualifications. No NBRC examination or certification submission is imposed by R 338.2205(1), unlike subsection (2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Prior Licensure
An active license or registration in good standing in another United States state immediately preceding application, held for at least five years.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.

Official no-examination sources

Effective from 2026-09-22.

Endorsement with fewer than five years of licensure United States or Canadian training
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Canadian Applicants
MCL 333.16186 requires substantially equivalent licensing standards and Canadian or United States education; subsection (3) permits an approved United States or Canadian national examination as evidence of equivalence. Any Canadian examination is a condition, and the department must consult the NBRC-CSRT reciprocity agreement in effect July 1, 2004.
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
Education
Complete a CoARC-accredited respiratory therapy program and earn at least a two-year associate degree from an accredited college or university meeting R 338.2206; send official transcripts directly to LARA.
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Nbrc Verification
NBRC must send an official credential verification directly to LARA.
Prior Licensure
Hold an active license or registration in good standing in another United States state, or an active license in a Canadian province, immediately before applying; fewer than five years of such licensure or registration.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.
Endorsement with fewer than five years of licensure foreign training
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Canadian Applicants
MCL 333.16186 requires substantially equivalent licensing standards and Canadian or United States education; subsection (3) permits an approved United States or Canadian national examination as evidence of equivalence. Any Canadian examination is a condition, and the department must consult the NBRC-CSRT reciprocity agreement in effect July 1, 2004.
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
Education
Complete a CoARC-accredited respiratory therapy program and earn at least a two-year associate degree from an accredited college or university meeting R 338.2206; send official transcripts directly to LARA.
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Foreign Education Evaluation
For education outside the United States or Canada, obtain a NACES-accredited evaluation meeting R 338.2202a.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Nbrc Verification
NBRC must send an official credential verification directly to LARA.
Prior Licensure
Hold an active license or registration in good standing in another United States state, or an active license in a Canadian province, immediately before applying; fewer than five years of such licensure or registration.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.
Initial licensure by examination United States or Canadian training
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
Education
Complete a CoARC-accredited respiratory therapy program and earn at least a two-year associate degree from an accredited college or university meeting R 338.2206; send official transcripts directly to LARA.
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Nbrc Verification
NBRC must send an official credential verification directly to LARA.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.
Initial licensure by examination training outside the United States or Canada
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the completed MiPLUS application and the applicable fee; disclose all health-profession licenses, registrations and certifications held elsewhere.
Criminal History
Submit fingerprints for the state and national criminal-history checks required by MCL 333.16174(3); relicensure within three years is exempt from the guide's new background-check requirement.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
Education
Complete a CoARC-accredited respiratory therapy program and earn at least a two-year associate degree from an accredited college or university meeting R 338.2206; send official transcripts directly to LARA.
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Foreign Education Evaluation
Training outside the United States or Canada requires an evaluation by a NACES-accredited organization establishing compliance with R 338.2202; the January 2026 guide also says foreign-trained applicants must meet the ordinary requirements.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Initial licensure requires at least two hours within the preceding five years under R 338.7004(1); renewal and relicensure require one hour for each year of the license cycle under R 338.7004(2).
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Nbrc Verification
NBRC must send an official credential verification directly to LARA.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.
Continuation during active military or federal public health service
No examination is required for this applicant pathway.
Notice
Notify the Board of entering service or federal employment and its cessation; the license continues until discharge or leaving service without further action.
Prior Michigan License
Hold the Michigan license at induction or entry into service and practice while in active United States military service, an auxiliary or the United States Public Health Service.

Official no-examination sources

Effective from 2026-09-22.

Initial license without examination for military members, veterans and dependents
No examination is required for this applicant pathway.
Competence
Demonstrate professional competence through training, experience or another departmental method.
Criminal History
Submit fingerprints under MCL 333.16174(3).
Eligibility
Be a member of the armed forces or uniformed services, a veteran, or an eligible dependent.
Other License
Hold a current license in good standing in another state or country with requirements substantially equivalent to or exceeding Michigan requirements.
Statutory Priority
MCL 333.16186a expressly grants the initial license without examination notwithstanding other provisions.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after revocation with a statutory five year waiting period
Application
Use MiPLUS, pay applicable fees, submit the criminal-history check and at least two notarized affidavits; comply with the final disciplinary order.
Current Examination
MCL 333.16247(2) expressly requires taking and passing the current licensure examination as a condition of reinstatement.
Hearing
After hearing, establish by clear and convincing evidence good moral character, safe and competent practice, compliance with adopted reinstatement guidelines, and the public interest in reinstatement.
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Prior Discipline
Revoked license for a ground requiring five years before reinstatement under MCL 333.16245(4); permanently revoked licenses cannot be reinstated.
Probation
One year of probation under Board-set conditions, with possible corrective measures and education under MCL 333.16247.
Rehabilitation
Supply the applicable guideline evidence of community service, treatment, discipline compliance, continuing education, remedial or refresher training, and professional skills assessment.
Relicensure current authorization elsewhere; lapse longer than three years
No examination is required for this applicant pathway.
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the relicensure application and fee and disclose other health-profession credentials with verification of no pending proceedings or sanctions in force.
Criminal History
Establish good moral character and submit fingerprints under the applicable table for a lapse longer than three years.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Complete the implicit-bias training required for relicensure by R 338.7004(2).
Lapse
Michigan license lapsed more than three years ago.
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Other Current Authorization
Hold a current valid respiratory care license, registration or certification in another United States state or Canadian province.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.

Official no-examination sources

Effective from 2026-09-22.

Relicensure current authorization elsewhere; lapse of three years or less
No examination is required for this applicant pathway.
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the relicensure application and fee and disclose other health-profession credentials with verification of no pending proceedings or sanctions in force.
Criminal History
The R 338.2205a table does not mark fresh fingerprints or good-moral-character documentation for a lapse of three years or less.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Complete the implicit-bias training required for relicensure by R 338.7004(2).
Lapse
Michigan license lapsed no more than three years ago.
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Other Current Authorization
Hold a current valid respiratory care license, registration or certification in another United States state or Canadian province.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.

Official no-examination sources

Effective from 2026-09-22.

Relicensure no current authorization elsewhere; lapse longer than three years
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the relicensure application and fee and disclose other health-profession credentials with verification of no pending proceedings or sanctions in force.
Criminal History
Establish good moral character and submit fingerprints under the applicable table for a lapse longer than three years.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Guide Demand
The January 26, 2026 licensing guide, pages 3-4, states: "Applicants who do not hold a current and valid respiratory care license, registration, or certification in another state of the United States or province of Canada must arrange for an official report" confirming a CRT or RRT examination pass within two years of the application. R 338.2205a(1)(a)(iv) marks that requirement only for a lapse longer than three years; the rule controls.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Complete the implicit-bias training required for relicensure by R 338.7004(2).
Lapse
Michigan license lapsed more than three years ago.
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Other Current Authorization
Do not hold a current valid respiratory care license, registration or certification in another United States state or Canadian province.
Recent Passing Score
Document passage of the NBRC examination required under R 338.2202 within the two years immediately preceding relicensure; the guide describes the window relative to application submission.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.
Relicensure no current authorization elsewhere; lapse of three years or less
No examination is required for this applicant pathway.
Age
At least 18 years old under MCL 333.16174(1)(a).
Application
Submit the relicensure application and fee and disclose other health-profession credentials with verification of no pending proceedings or sanctions in force.
Criminal History
The R 338.2205a table does not mark fresh fingerprints or good-moral-character documentation for a lapse of three years or less.
Disciplinary History
Provide direct verification from every issuing licensing authority; no pending disciplinary proceedings or sanctions in force, and consent to release disciplinary-investigation information under MCL 333.16174(2).
English Language
Demonstrate a working knowledge of English under R 338.7002b: English-taught professional education, at least 60 college credits from an English-speaking institution, board-approved credential evaluation, or the rule's accepted Cambridge English, ECCE, ECPE, IELTS Academic, MET, OET, Pearson PTE Academic, TOEFL-IBT or TOEIC scores and applicable time windows. Language tests are applicant conditions.
Good Moral Character
Establish good moral character and provide explanatory documentation for affirmative application answers.
Guide Demand
The January 26, 2026 licensing guide, pages 3-4, states: "Applicants who do not hold a current and valid respiratory care license, registration, or certification in another state of the United States or province of Canada must arrange for an official report" confirming a CRT or RRT examination pass within two years of the application. R 338.2205a(1)(a)(iv) marks that requirement only for a lapse longer than three years; the rule controls.
Human Trafficking
Complete the one-time human-trafficking identification training meeting R 338.2201a.
Implicit Bias
Complete the implicit-bias training required for relicensure by R 338.7004(2).
Lapse
Michigan license lapsed no more than three years ago.
Medical Records Policy
Supply the affidavit of a written medical-records protection, maintenance and access policy required by MCL 333.16177(4).
Other Current Authorization
Do not hold a current valid respiratory care license, registration or certification in another United States state or Canadian province.
Social Security Number
Provide the Social Security number or the legally applicable exemption affidavit under MCL 333.16177.

Official no-examination sources

Effective from 2026-09-22.

Timely renewal
No examination is required for this applicant pathway.
Attestation
Affirm renewal compliance and disclose criminal and disciplinary matters as requested.
Late Renewal
Submit the MiPLUS renewal application and renewal fee before the expiration date.
Renewal Cycle
Renew every three years under R 338.7002(2), on or before expiry; the guide permits online application within 90 days before expiry.
Training
Complete one-time human-trafficking training and one hour of implicit-bias training for each year of the license cycle.

Official no-examination sources

Effective from 2026-09-22.

Renewal within the 60 day grace period
No examination is required for this applicant pathway.
Attestation
Affirm renewal compliance and disclose criminal and disciplinary matters as requested.
Late Renewal
If within 60 days after expiration, pay renewal and late fees and meet applicable training requirements; MCL 333.16201(2) expressly permits continued practice during those 60 days.
Renewal Cycle
Renew every three years under R 338.7002(2), on or before expiry; the guide permits online application within 90 days before expiry.
Training
Complete one-time human-trafficking training and one hour of implicit-bias training for each year of the license cycle.

Official no-examination sources

Effective from 2026-09-22.

Temporary Respiratory Therapist License

Temporary license under MCL 333.16181, including examination-pending applicants and applicants with an active license elsewhere; distinct from the expired 2004 grandfather program.

Licensing authority: Michigan Department of Licensing and Regulatory Affairs / Michigan Board of Respiratory Care · Application information

Temporary issuance on proof of an active license elsewhere
No examination is required for this applicant pathway.
Issuance
MCL 333.16181(4) requires issuance within 48 hours on receipt of that proof; further ordinary Michigan licensing qualifications are separate applicant conditions.
Other License
Provide proof of a currently active license in good standing from another United States state or Canadian province.

Official no-examination sources

Effective from 2026-09-22.

Temporary license pending the required examination
Duration
Nonrenewable and valid for 18 months; automatically void if the required examination or evaluation is failed.
Eligibility
Complete all licensure requirements except the examination or required evaluation; no prior failed examination or evaluation and no suspended or revoked license.
Exam Timing
The NBRC qualification is pending at issuance. The route still involves the currently offered examinations, which the contract retains as leaves even when taken after application.
Nbrc Credential Alternatives
Michigan accepts the NBRC CRT credential (TMC) or RRT credential (TMC at its higher cut score plus Clinical Simulation Examination). The official skilled-immigrant guide calls Clinical Simulation Examination "CME"; its full name and RRT context identify the supplied CSE. Historical predecessor credentials remain applicant evidence, while the currently offered registered examinations remain leaves, irrespective of when the credential was earned.
Supervision
Practice only under an unrestricted licensee of the same profession under MCL 333.16181(3).
Temporary license pending relicensure within three years of lapse
No examination is required for this applicant pathway.
Lapse
Seek relicensure within three years under MCL 333.16201(3); temporary issuance is discretionary pending action on that application.
Relicensure
Meet the applicable within-three-years application, fees, disclosure and training requirements of R 338.2205a.
Supervision
Temporary practice remains subject to MCL 333.16181 supervision requirements where applicable.

Official no-examination sources

Effective from 2026-09-22.

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