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Washington Respiratory Therapy — Requirements & Free Practice

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Respiratory Care Practitioner License

Washington license for practice of respiratory care; military and inactive military-related statuses remain statuses of this credential.

Licensing authority: Washington State Department of Health — Secretary of Health · Application information

Licensure based on Canadian education and CSRT examination or registration
No examination is required for this applicant pathway.
Canadian examination or registration
Pass the CSRT registry examination or hold a registration issued by CSRT; the Canadian examination is an applicant condition and is not a United States exam leaf. These satisfy education and examination requirements under WAC 246-928-560(3).
Education
Complete at least a two-year program recognized by CSRT in its current or previous lists.
Verification
Verification must come directly from CSRT. Submit the application, fee, and any other information required by WAC 246-928-420(1).

Official no-examination sources

Effective from 2025-07-01.

Reinstatement after disciplinary suspension
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Discretionary exam slot
RCW 18.130.150 permits successful completion of an examination as a reinstatement condition, but identifies no examination. Any case-specific examination requirement remains a condition; no examination identity is inferred.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Order
Meet every condition in the disciplinary order, pay renewal fees if due and any required monitoring surcharge, and declare compliance with CE and competency for the entire suspension.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Petition
Petition after the interval fixed by the disciplinary order; reinstatement is unavailable when the authority determined the person can never be rehabilitated or regain safe practice. The authority holds a hearing and may deny or impose reinstatement conditions.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Reactivation after expiration for one renewal cycle or less
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Expiration
Expired for one renewal cycle or less; provide required declarations and comply with current CE or competency requirements.
Fees
Pay the late renewal penalty and current renewal fee, and monitoring surcharge if the profession requires it.
Initial exam changes
The Department FAQ states that previously licensed Washington RCPs who let their license lapse need not meet the new initial-licensure examination requirements to reactivate it.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Practice
An expired credential does not authorize practice; return it to active status before practicing.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Reactivation after expiration for three years or more
Application
Submit abbreviated application and expired-credential reissuance fee. Declare no action restricting practice, no voluntary surrender or restriction to avoid formal action, and compliance with CE or competency for the two most recent years.
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Expiration
Expired for three years or more.
Fees
Pay the late renewal penalty and current renewal fee, and monitoring surcharge if the profession requires it.
Initial exam changes
The Department FAQ states that previously licensed Washington RCPs who let their license lapse need not meet the new initial-licensure examination requirements to reactivate it.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other competency
Satisfy any other competency requirements the regulatory entity requires; the rule identifies no additional examination. The Department’s currently linked September 2021 activation packet requires experience history, disciplinary declarations, and CE/competency declarations.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Practice
An expired credential does not authorize practice; return it to active status before practicing.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Reactivation after more than one renewal cycle but less than three years
Application
Submit abbreviated application and expired-credential reissuance fee. Declare no action restricting practice, no voluntary surrender or restriction to avoid formal action, and compliance with CE and competency for the two most recent years.
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Expiration
Expired for more than one renewal cycle but less than three years.
Fees
Pay the late renewal penalty and current renewal fee, and monitoring surcharge if the profession requires it.
Initial exam changes
The Department FAQ states that previously licensed Washington RCPs who let their license lapse need not meet the new initial-licensure examination requirements to reactivate it.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Practice
An expired credential does not authorize practice; return it to active status before practicing.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Initial licensure by approved education and examination
Application
Submit the Department application and nonrefundable fee; provide any additional information the Department requires (WAC 246-928-420).
Education
Graduate from an accredited respiratory therapy educational program of at least two years; provide an official transcript (WAC 246-928-520).
Exam evidence
Pass TMC and CSE, or provide an active NBRC Registered Respiratory Therapist credential as proof of meeting the examination requirements under WAC 246-928-540(2); no new sitting is required when the credential supplies proof.
Fitness
Meet good-moral-character and any experience requirements; denial or conditional-licensure grounds under the Uniform Disciplinary Act apply (RCW 18.89.090).
Verification
List all jurisdictions in which credentials were held or applied for; licensing jurisdictions and the issuing school or NBRC must send verification directly to the Department. Answer personal-data questions with the required explanations and documentation.
Initial licensure with military training or experience evaluation
Application
Submit the Department application and nonrefundable fee; provide any additional information the Department requires (WAC 246-928-420).
Education
Graduate from an accredited respiratory therapy educational program of at least two years; provide an official transcript (WAC 246-928-520).
Exam evidence
Pass TMC and CSE, or provide an active NBRC Registered Respiratory Therapist credential as proof of meeting the examination requirements under WAC 246-928-540(2); no new sitting is required when the credential supplies proof.
Fitness
Meet good-moral-character and any experience requirements; denial or conditional-licensure grounds under the Uniform Disciplinary Act apply (RCW 18.89.090).
Military training
Military training or experience satisfies the corresponding requirements unless the Secretary determines it is not substantially equivalent to Washington standards (RCW 18.89.095); request evaluation and provide official military documentation.
Verification
List all jurisdictions in which credentials were held or applied for; licensing jurisdictions and the issuing school or NBRC must send verification directly to the Department. Answer personal-data questions with the required explanations and documentation.
Return to active status after mandated suspension
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Declarations
Attest to CE and competency for the entire suspension period and submit required documentation.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Long suspension
If suspension exceeded three years, also meet any profession-specific requirements identified by rule.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Support order
For support-order suspension, provide the release showing compliance; automatic reissuance applies if all other reinstatement requirements were maintained (RCW 18.130.150).
Suspension
Meet all requirements in the mandatory-suspension order; pay current renewal fee if due, any required monitoring surcharge, and the return-from-mandated-suspension fee.
Maintain inactive military related status
No examination is required for this applicant pathway.
Eligibility
Continue the marriage or registered domestic partnership while the service member remains stationed or deployed outside Washington; submit official orders with maintenance requests. CE is not required in this status.

Official no-examination sources

Effective from 2026-06-14.

Obtain inactive military related status
No examination is required for this applicant pathway.
Documentation
Submit written request, official service orders, and marriage or registered-domestic-partnership certificate.
Effect
No status fee; Washington practice is prohibited in this inactive status.
Eligibility
Hold an active valid Washington credential; be a spouse or registered domestic partner of an Armed Forces or Public Health Service member stationed or deployed outside Washington.

Official no-examination sources

Effective from 2026-06-14.

Return from inactive military related status to active status
No examination is required for this applicant pathway.
Documentation
Pay active renewal fee and any required monitoring surcharge; submit service or discharge status documentation.
Timing
Return may occur at any time. After the service member qualifying discharge, provide DD214 and change to active within six months; otherwise late fees apply. CE applies during the following renewal.

Official no-examination sources

Effective from 2026-06-14.

Maintain military status
No examination is required for this applicant pathway.
Service
While military service continues, submit official service orders with maintenance notices; renewal and continuing education are not required.

Official no-examination sources

Effective from 2026-06-14.

Obtain military status for the existing license
No examination is required for this applicant pathway.
Effect
No status fee; the credential remains valid during service and permits Washington practice unless suspended or revoked.
Eligibility
Hold an active Washington credential valid and in force and effect; submit a written request and official service orders proving membership in the Armed Forces, Public Health Service Commissioned Corps, or Merchant Marine.

Official no-examination sources

Effective from 2026-06-14.

Return from military status to active status
No examination is required for this applicant pathway.
Documentation
Submit written service-status notification, official DD214 discharge papers, active renewal fee, and any required monitoring surcharge.
Timing
Change to active within six months of qualifying discharge; otherwise late fees apply. CE applies after the first post-discharge renewal.

Official no-examination sources

Effective from 2026-06-14.

Licensure based on current NBRC Registered Respiratory Therapist certification
No examination is required for this applicant pathway.
Application
Submit the Department application, certification proof, proof of compliance with RCW 18.130.077(3), and applicable fees.
Board faq demand
The Department FAQ states: "As of July 1, 2022, all applicants for the RCP license must pass both the therapist multiple choice examination and the clinical simulation examination. This change is consistent with the National Board of Respiratory Care (NBRC) requirement to be a Registered Respiratory Therapist (RRT) rather than a Certified Respiratory Therapist (CRT). " The specific later rule WAC 246-928-575, implementing RCW 18.130.077(2), supplies this certification pathway.
Certification
Provide proof of current national certification as a Registered Respiratory Therapist from NBRC or its predecessor in good standing. WAC 246-928-575 grants licensure on this certification rather than requiring passage of identified currently offered examinations in this distinct waiver pathway.
Discretion
The statute permits waiver for national certification, and WAC 246-928-575 provides that the applicant may be granted Washington licensure.
Fitness
Provide proof of compliance with RCW 18.130.077(3), including absence of disqualifying license grounds, recent disciplinary action, and pending investigation or charges.

Official no-examination sources

Effective from 2025-07-01.

Licensure by substantially equivalent out of state credentials
No examination is required for this applicant pathway.
Application
Submit application, fee, and direct credential verification as required by WAC 246-928-560(1).
Board faq demand
The Department FAQ states: "As of July 1, 2022, all applicants for the RCP license must pass both the therapist multiple choice examination and the clinical simulation examination. This change is consistent with the National Board of Respiratory Care (NBRC) requirement to be a Registered Respiratory Therapist (RRT) rather than a Certified Respiratory Therapist (CRT). " The specific statutory waiver in RCW 18.130.077(1), implemented by WAC 246-928-560(1), controls this credential route.
Fitness
Meet RCW 18.130.077(3): no denial or conditional-license ground; no disciplinary action for unprofessional conduct or impairment during the preceding two years or application pendency; no investigation or charges during application pendency.
Licensure history
Credentialed for at least two years immediately before application in one or more jurisdictions with substantially equivalent standards, with no licensure interruption longer than 90 days. Verification must attest to a current license in good standing.

Official no-examination sources

Effective from 2025-07-01.

Licensure for out of state applicants subject to standard Washington requirements
Application
Submit the Department application and nonrefundable fee; provide any additional information the Department requires (WAC 246-928-420).
Education
Graduate from an accredited respiratory therapy educational program of at least two years; provide an official transcript (WAC 246-928-520).
Exam evidence
Pass TMC and CSE, or provide an active NBRC Registered Respiratory Therapist credential as proof of meeting the examination requirements under WAC 246-928-540(2); no new sitting is required when the credential supplies proof.
Fitness
Meet good-moral-character and any experience requirements; denial or conditional-licensure grounds under the Uniform Disciplinary Act apply (RCW 18.89.090).
Out of jurisdiction
Previously or currently credentialed outside Washington, but licensed for less than two years in a substantially equivalent jurisdiction, credentialed in a non-equivalent jurisdiction, or expired elsewhere: meet the ordinary Washington requirements (WAC 246-928-560(2)).
Reciprocity discretion
RCW 18.89.150 permits licensure without examination when the Secretary determines substantially equivalent standards; the implemented two-year waiver is stated separately in WAC 246-928-560(1).
Verification
List all jurisdictions in which credentials were held or applied for; licensing jurisdictions and the issuing school or NBRC must send verification directly to the Department. Answer personal-data questions with the required explanations and documentation.
Biennial license renewal
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Initial exam changes
The Department FAQ states that existing licensees need not meet the new initial-licensure examination requirements to maintain a license.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Renewal
Submit renewal form, fee, and CE declarations; renew every two years on the practitioner birthday.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.
Return from retired volunteer licensure to the ordinary active respiratory care license
Asthma educator exam
WAC 246-928-442(3)(d)(iv) accepts the Certified Asthma Educator examination formerly owned by NAECB. The NBRC announcement states the AE-C examination continued without disruption after the September 1, 2022 transfer. No supplied version registers this accepted national examination; it remains a condition.
Continuing education
Complete 30 respiratory-care CE hours every two years, including at least 10 AARC-approved hours, two hours of qualifying health-equity training, and 18 remaining eligible hours. Keep records for four years and attest at renewal.
Exam credit
Ten hours may be claimed for passing TMC combined with CSE that awards NBRC registration; five hours may be claimed for the TMC that awards NBRC certification. The amount of CE credited depends on the qualification obtained.
Exam optional
WAC 246-928-442 permits non-examination courses, instruction, and related studies to satisfy CE. No new examination sitting is universally required for renewal or reactivation. Registered examination leaves show permitted CE examination options only.
Open specialty examination slot
The rule also accepts any NBRC specialty examination without naming an exhaustive examination set. This open approval slot is a condition, not an invented exam leaf.
Other profession certifications
The rule accepts initial or renewal ACLS, NALS/NRP, and PALS certifications for ten hours each and BLS for five hours; these other-scope certifications remain conditions.
Prior status
Hold a retired volunteer medical worker license based on a prior respiratory care license.
Pulmonary function exam
WAC 246-928-442(3)(c)(ii) accepts the examination earning Registered Pulmonary Function Technologist. The NBRC notice records that the former CPFT and RPFT programs merged in June 2015; the current Pulmonary Function Technology (PFT) examination earns RPFT at the high cut score. This accepted national examination has no supplied registered version and remains a condition.
Return requirements
WAC 246-12-450 sends this transition to WAC 246-12-040: satisfy the expiration-duration category, its fees, abbreviated application where required, fitness declarations, and applicable CE or competency; any additional competency requirement is a condition.
Self assessment slot
The rule accepts an NBRC self-assessment competency examination with a minimum score of 75, without identifying which respiratory-care self-assessment instrument must be used. This nonspecific examination slot remains a condition.

Respiratory Care Practitioner Temporary Practice Permit

One-time permit pending licensure for qualifying out-of-jurisdiction applicants; also available to qualifying military spouses or registered domestic partners.

Licensing authority: Washington State Department of Health — Secretary of Health · Application information

Military spouse temporary permit subject to ordinary professional qualification standards
Application
Submit the full-license application, applicable fees, fingerprint card if required, license verification, and written request for the temporary permit.
Duration
Full scope of practice; permit expires when the license is granted, a notice of decision is sent unless it specifically extends duration, or 180 days after issuance.
Full qualifications
If the two-year credentials waiver does not apply, meet the profession training, education, and practice requirements before the military-spouse permit is issued, including the examination standards in WAC 246-928-540; active RRT can supply proof.
Other license
Hold an unrestricted active license from a jurisdiction with substantially equivalent standards and no pending investigation, charges, or disciplinary action.
Relationship
Military spouse or registered domestic partner moving to Washington because of the service member transfer; provide service orders and proof of marriage or registered domestic partnership.
Military spouse temporary permit with qualifying two year statutory credentials waiver
No examination is required for this applicant pathway.
Application
Submit the full-license application, applicable fees, fingerprint card if required, license verification, and written request for the temporary permit.
Duration
Full scope of practice; permit expires when the license is granted, a notice of decision is sent unless it specifically extends duration, or 180 days after issuance.
Other license
Hold an unrestricted active license from a jurisdiction with substantially equivalent standards and no pending investigation, charges, or disciplinary action.
Relationship
Military spouse or registered domestic partner moving to Washington because of the service member transfer; provide service orders and proof of marriage or registered domestic partnership.
Statutory waiver
Meet RCW 18.130.077(1) and (3), including at least two years of qualifying credentials immediately preceding application with no interruption longer than 90 days; examination requirements are waived.

Official no-examination sources

Effective from 2026-06-14.

Temporary practice permit pending licensure for out of jurisdiction licensees
No examination is required for this applicant pathway.
Application
Submit application requesting the temporary practice permit, license-application fee, and permit fee.
Current license
Currently credentialed in another jurisdiction with substantially equivalent standards; all current and past licensing jurisdictions must verify good standing and absence of charges or disciplinary action for unprofessional conduct or impairment.
Duration
One-time permit expires on issuance of the full license, initiation of an investigation, or within 180 days, whichever comes first; it cannot be extended and does not ensure a full license.
Eligibility
The Department must find no basis for license denial or a conditional license. RCW 18.130.075 permits practice pending completion of documentation of full-license qualifications; WAC 246-928-570 lists no examination requirement for this permit.

Official no-examination sources

Effective from 2025-07-01.

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