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South Carolina Respiratory Therapy — Requirements & Free Practice

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Respiratory Care Practitioner

Permanent respiratory care practitioner license, covering respiratory therapists and respiratory therapy technicians. Statutory exemptions in Section 40-47-530 do not create additional respiratory care practitioner licenses. The Board permanently bars readmission after revocation under its published policy and Section 40-1-120(A)(4).

Licensing authority: South Carolina Board of Medical Examiners · Application information

Initial licensure after a Board approved apprenticeship
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Apprenticeship
Section 40-1-77 applies only to a qualifying Board-approved apprenticeship with a Board-determined similar scope of practice, not to licenses requiring a bachelor degree or higher or apprenticeships established by state law. Applicant must complete the apprenticeship, all otherwise applicable initial requirements, requisite examinations and fees, and meet criminal-conviction eligibility. This survey does not assert that a particular respiratory-care apprenticeship is approved.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Reinstatement after suspension for a dishonored payment without a five year practice gap
No examination is required for this applicant pathway.
Payment
Section 40-1-50(G) permits reinstatement after payment of the fee and statutory or regulatory penalties for a dishonored payment.
Practice
Applicant has not ceased practicing respiratory care for five years or more. The five-year clinical-competency policy does not apply. Case-specific Board conditions remain applicant conditions.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after suspension for a dishonored payment with a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
Payment
Section 40-1-50(G) permits reinstatement after payment of the fee and statutory or regulatory penalties for a dishonored payment.
Practice gap
The applicant has not practiced respiratory care for five years or more.
Licensure based on an equivalent out of state license
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other jurisdiction
Applicant is a respiratory therapist or respiratory therapy technician licensed in another state, territory, or the District of Columbia. Under Section 40-47-610(A), the Board decides whether requirements are substantially equal. The Board application still requests CRT or RRT certification or results; an accepted existing passing score is not a new-examination mandate.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Conditional renewal or reinstatement for financial hardship without a five year practice gap
No examination is required for this applicant pathway.
Hardship
Under Section 40-1-170(D), the Board may conditionally renew or reinstate for at most one year after a demonstration of financial hardship and a formal agreement to reimburse unpaid disciplinary costs within that year.
Practice
Applicant has not ceased practicing respiratory care for five years or more. The five-year clinical-competency policy does not apply. Case-specific Board conditions remain applicant conditions.

Official no-examination sources

Effective from 2026-09-22.

Conditional renewal or reinstatement for financial hardship with a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
Hardship
Under Section 40-1-170(D), the Board may conditionally renew or reinstate for at most one year after a demonstration of financial hardship and a formal agreement to reimburse unpaid disciplinary costs within that year.
Practice gap
The applicant has not practiced respiratory care for five years or more.
Renewal retaining inactive status
No examination is required for this applicant pathway.
Continuing education
Regulation 81-202 requires fifteen approved continuing-education hours in the twelve months before its March 1 annual renewal date. The Board current page uses a 24-month CME period and says first-cycle permanent licensees need no CME. The regulation controls; the lower-ranked Board instructions are retained as conditions for the applicant to reconcile with the Board.
Current reactivation cutoff
The Board page lists the respiratory-care late-renewal period as June 1, 2025 through May 31, 2026 and requires the reactivation application beginning June 1, 2026. No late-renewal window is asserted to be open on September 22, 2026.
Existing license
Hold a permanent license and submit the renewal application and applicable renewal fee; late-renewal fees apply within a Board-authorized window.
Inactive status
Renewal of an inactive license does not authorize practice until reactivation under Section 40-47-640(B).
Military exemptions
Sections 40-1-610 and 40-1-620 provide active-duty continuing-education and fee exemptions. The Board says exempt applicants cannot renew online and must request a paper application.
Practice limit
This route renews the inactive authorization only; it does not authorize a return to respiratory-care practice and does not substitute for the separate reactivation routes.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by examination
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Conversion from limited to permanent licensure
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Limited status
Applicant holds the limited license and supplies CRT or RRT certification and the respiratory program diploma. The Board FAQ says to apply for the permanent license within six months after graduation and lists an $80 update fee.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Expedited permanent licensure for an eligible military spouse
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Military spouse
Hold an active license in good standing elsewhere, be married to and living with an active-duty service member relocated to South Carolina by official orders, submit the expedited request, orders, marriage license and verification from every licensing jurisdiction. Expedited processing does not waive the underlying respiratory-care requirements.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Initial licensure with military education, training, and experience credited
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Military credit
Under Section 40-1-640, provide satisfactory evidence of military education, training and experience; the Board applies it in the most favorable manner toward eligibility. This does not automatically dispense with examinations or the remaining standards.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Reactivation or reinstatement of an inactive or lapsed license without a five year practice gap
No examination is required for this applicant pathway.
Continuing education
The reactivation application requires thirty continuing-medical-education hours obtained within two years of applying, documented by certificates, diploma or printout.
Documents
Provide the $160 reactivation fee, government photo identification, Social Security documentation, recent photograph, verification from all other licensing jurisdictions, legal-name-change documentation when applicable, physician sponsor statement for home care and Board-directed criminal background check.
History
List all practice and employment since becoming inactive and explain all affirmative personal-history answers. The application remains usable for one year.
Practice
Applicant has not ceased practicing respiratory care for five years or more; the five-year competency-examination policy does not apply.
Previous license
Previously held South Carolina respiratory-care licensure is inactive or lapsed. Complete the reactivation application.

Official no-examination sources

Effective from 2026-09-22.

Reactivation after a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Continuing education
The reactivation application requires thirty continuing-medical-education hours obtained within two years of applying, documented by certificates, diploma or printout.
Documents
Provide the $160 reactivation fee, government photo identification, Social Security documentation, recent photograph, verification from all other licensing jurisdictions, legal-name-change documentation when applicable, physician sponsor statement for home care and Board-directed criminal background check.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
History
List all practice and employment since becoming inactive and explain all affirmative personal-history answers. The application remains usable for one year.
Practice gap
The applicant has not practiced respiratory care for five years or more.
Previous license
Previously held South Carolina respiratory-care licensure is inactive or lapsed. Complete the reactivation application.
Renewal while current clinical practice has been maintained
No examination is required for this applicant pathway.
Continuing education
Regulation 81-202 requires fifteen approved continuing-education hours in the twelve months before its March 1 annual renewal date. The Board current page uses a 24-month CME period and says first-cycle permanent licensees need no CME. The regulation controls; the lower-ranked Board instructions are retained as conditions for the applicant to reconcile with the Board.
Current reactivation cutoff
The Board page lists the respiratory-care late-renewal period as June 1, 2025 through May 31, 2026 and requires the reactivation application beginning June 1, 2026. No late-renewal window is asserted to be open on September 22, 2026.
Existing license
Hold a permanent license and submit the renewal application and applicable renewal fee; late-renewal fees apply within a Board-authorized window.
Inactive status
Renewal of an inactive license does not authorize practice until reactivation under Section 40-47-640(B).
Military exemptions
Sections 40-1-610 and 40-1-620 provide active-duty continuing-education and fee exemptions. The Board says exempt applicants cannot renew online and must request a paper application.
Practice
Applicant has not ceased respiratory-care practice for five years or more. The five-year competency examination policy does not apply to this condition.

Official no-examination sources

Effective from 2026-09-22.

Renewal for a practitioner with a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Continuing education
Regulation 81-202 requires fifteen approved continuing-education hours in the twelve months before its March 1 annual renewal date. The Board current page uses a 24-month CME period and says first-cycle permanent licensees need no CME. The regulation controls; the lower-ranked Board instructions are retained as conditions for the applicant to reconcile with the Board.
Current reactivation cutoff
The Board page lists the respiratory-care late-renewal period as June 1, 2025 through May 31, 2026 and requires the reactivation application beginning June 1, 2026. No late-renewal window is asserted to be open on September 22, 2026.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
Existing license
Hold a permanent license and submit the renewal application and applicable renewal fee; late-renewal fees apply within a Board-authorized window.
Inactive status
Renewal of an inactive license does not authorize practice until reactivation under Section 40-47-640(B).
Military exemptions
Sections 40-1-610 and 40-1-620 provide active-duty continuing-education and fee exemptions. The Board says exempt applicants cannot renew online and must request a paper application.
Practice gap
The applicant has not practiced respiratory care for five years or more.
Reinstatement after voluntary surrender without a five year practice gap
No examination is required for this applicant pathway.
Practice
Applicant has not ceased practicing respiratory care for five years or more. The five-year clinical-competency policy does not apply. Case-specific Board conditions remain applicant conditions.
Surrender
The Board must reinstate the license by majority vote. Surrender does not bar disciplinary action; comply with any conditions imposed before reinstatement.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after voluntary surrender with a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
Practice gap
The applicant has not practiced respiratory care for five years or more.
Surrender
The Board must reinstate the license by majority vote. Surrender does not bar disciplinary action; comply with any conditions imposed before reinstatement.
Reinstatement after disciplinary suspension without a five year practice gap
No examination is required for this applicant pathway.
Discipline
This is reinstatement of a suspended license, not readmission after revocation. Satisfy the disciplinary order and Board-imposed conditions and pay renewal and applicable late fees.
Practice
Applicant has not ceased practicing respiratory care for five years or more. The five-year clinical-competency policy does not apply. Case-specific Board conditions remain applicant conditions.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after disciplinary suspension with a five year practice gap
Therapist Multiple-Choice Examination
Board review
Submit the application and fee; staff sends it to the Respiratory Care Committee for its recommendation, and the Board grants or denies the application.
Discipline
This is reinstatement of a suspended license, not readmission after revocation. Satisfy the disciplinary order and Board-imposed conditions and pay renewal and applicable late fees.
Education
The policy additionally requires fifteen or more approved contact hours within the immediately preceding twelve months.
Exam score window
The July 17-18, 2000 policy requires passage of the NBRC entry-level examination within the immediately preceding five years. Its date limit is an applicant condition, not an examination version end date.
Practice gap
The applicant has not practiced respiratory care for five years or more.

Temporary Professional License — Respiratory Care Practitioner (Military Spouse)

One-year, nonrenewable temporary professional license for an eligible military spouse; all state licensing requirements must be met.

Licensing authority: South Carolina Board of Medical Examiners · Application information

Temporary professional licensure for a military spouse
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Military spouse
Provide proof of marriage to an active-duty service member assigned to South Carolina under official orders; hold a valid comparable license in good standing from another state, the District of Columbia, a United States territory or possession, or a foreign jurisdiction; meet all state-law licensure requirements. Fingerprint checks apply if ordinary licensure requires a similar check. The temporary license expires one year after issue and cannot be renewed.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."

Temporary Respiratory Care Practitioner License

Temporary license that the Board may issue after all licensing requirements have been met.

Licensing authority: South Carolina Board of Medical Examiners · Application information

Temporary licensure after satisfying equivalent license requirements
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Equivalent license
Hold a respiratory therapy license in another state, territory or the District of Columbia with requirements the Board finds substantially equal.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Temporary issuance
Section 40-47-625 permits the Board to issue a temporary license only after all licensing requirements have been met. No term or renewal entitlement is inferred.
Temporary licensure after satisfying initial examination requirements
Application
Submit a completed Board application; it remains usable for one year from receipt. The July 2026 application fee is $110; earlier $120 amounts in the undated FAQ are superseded by that application.
Approved alternative
Section 40-47-600 also permits another examination or requirement administered or approved by the committee. The unnamed open remainder is an applicant condition, with no invented exam leaf.
Certification alternatives
The state accepts CRT or RRT. The Board FAQ identifies TMC lower-cut-score CRT, TMC higher-cut-score RRT eligibility and CSE eligibility; preserve TMC for CRT or TMC together with CSE for the RRT examination pathway. CSE is an alternative-pathway leaf, not an additional universal requirement.
Certification evidence
Provide a current NBRC CRT or RRT certificate or the certification examination results; direct NBRC verification may be required.
Education
Provide a respiratory care diploma or transcript from the approved respiratory care program; Section 40-47-510(5) defines the approved educational program.
Exam timing
Passing a currently offered examination before applying remains part of this route. A historical score or certification is acceptable when the Board accepts it; this tree does not require every applicant to retake all referenced examinations.
Identity and presence
Submit government photo identification, Social Security documentation, a notarized lawful-presence affidavit, a recent 2-by-2-inch photograph, and legal-name or name-change documentation.
Medical direction
Identify the South Carolina employer and medical director before working; a home-care applicant must provide the physician sponsor statement.
Moral character
The July 2026 application lists good moral character. Section 40-1-140(A)(2) prohibits using vague or generic terms such as good character, or dismissed, nol-prossed, or not-guilty charges, as a justification for denying a license. Criminal convictions must directly relate to the occupation under Section 40-1-140(A)(1), with a hearing and written-order protections.
Other licenses
List every current or former medical-profession license and obtain official verification directly from each issuing board.
Personal history
Complete the application personal-history questions concerning practice interruptions, criminal matters, impairment, malpractice, disciplinary actions, denials, investigations, surrendered licenses or privileges, and resignations; explain affirmative answers and supply the supporting documents requested by the form.
Practice gap
The July 2026 instructions state: "Note: It is the policy of the Board to require individuals who have not actively practiced Respiratory Care for Five (5) Years or more to take and pass the NBRC-Entry Level Examination. Proof of passage must be provided to the Board before your license is issued."
Temporary issuance
Section 40-47-625 permits the Board to issue a temporary license only after all licensing requirements have been met. No term or renewal entitlement is inferred.

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