The work of respiratory therapists (RTs), and the essential care they provide to people living with chronic conditions like asthma or COPD as well as those with acute respiratory illness like influenza, is widely recognized by both the people they care for and the colleagues they work alongside. But for the general public, the specialized skills and support that RTs provide for patients who are struggling to breathe, was thrust into the spotlight largely due to the COVID-19 pandemic.
As experts in airway management, RTs provide breathing treatments and support for people with chronic and acute lung diseases but also manage airways for anyone in need of mechanical ventilation. They are a critical support within all health care environments – in hospital, long term care facilities, community settings and as part of interprofessional emergency critical care and transport teams. In the response to COVID-19, the expertise of RTs has been in high demand.
“Unless you were there, it’s hard to describe the experience of the past few years,” said Perry Komonko, an Advanced Practice RT and founding member of the Adult Patient Transport team who has been involved in the safe transport of patients requiring breathing support for more than 22 years.
“Wearing full PPE, sweat running down our backs, transferring very challenging and critically ill patients, and constantly worrying about the COVID patients whose condition could take a turn, often without any warning.”
COVID is not the first time that RTs have been asked to commit their skills to a pandemic response. RTs are highly trained to conduct respiratory tests, monitor oxygen levels and support patients in need of specialized equipment and are regularly called upon during respiratory virus outbreaks – whether influenza, SARS, H1N1, and now COVID-19 –to help people breathe.
It’s a role that does not have a “typical” day, with treatments and tasks largely determined by the care environment and patient population being supported.
“In our heads, we are constantly running through every scenario of what might lie ahead, what might happen and then what we would do, how we would react and intervene,” said Komonko. “Anticipating and reacting are key skills that RTs develop over time. Regular skill days in the simulation lab are so important to an RT’s ability to anticipate and react, while keeping up and evolving our practice.”
Komonko supports the continuous education of a number of colleagues in his role as a Clinical Services Lead, supporting RTs in practicing scenarios with conditions they may not often encounter, allowing them to refresh their training on equipment and with skills they may require when caring for a patient.
“I hope that my experience and my history can support the team and offer a voice of reason or guidance that will help them as they manage their patients,” added Komonko.
It’s this supportive environment, where experiences are shared and ongoing learning is prioritized, that has kept Todd Mortimer, an Advanced Practice RT and Clinical Services Lead with the Child Health Transport Team, energized and invested in his work as a RT for more than 33 years.
“It’s a bit more of an obscure allied health profession but it’s a fascinating field with broad opportunities to work in so many different areas, whether acute, critical care, long-term, chronic,” said Mortimer. “No matter what area you work in, however, you need to be nimble, a problem-solver, able to adapt and able to collaborate. We work with so many other members of different health professions.”
COVID-19 isn’t Mortimer’s first pandemic. In 2009, he worked on the front-lines of Manitoba’s response to H1N1, supporting the care of children admitted to the pediatric intensive care unit at HSC Winnipeg’s Children’s Hospital. His experience – and the role of respiratory therapists in “Helping Kids Breathe Easier” helped to inspire the next generation of RTs, including John Huynh.
“I became an RT approximately nine years ago after seeing a feature about the role of RTs at HSC Children’s during the H1N1 virus,” said Huynh, an RT and member of the Shared Health Inter-Facility Patient Transport Team. “RTs were obviously making a big difference for all of those kids, supporting their breathing. I investigated the role further and I’m so glad to this day that I kind of stumbled onto this profession.”
“Respiratory therapy is the perfect profession for anyone who wants to work in a career that involves close human connections and has a commitment to lifelong learning. Every single day you will make a difference and learn something new,” added Huynh.
The next generation of RTs includes new graduates like Hannah Chale, who has been on the job for only a few months since completing her education at the University of Manitoba Rady Faculty of Health Sciences.
“I finished my schooling but I have my entire life to learn about the role of RT and how we can improve the quality of care for our patients,” said Chale who works as a member of the Adult RT team at HSC. “I can’t say enough about how much I love that this profession will continue to evolve, grow my skills and change over time. The learning doesn’t stop when you finish school.”
“RTs play a critical role in the hospital and in the community helping with the treatment of respiratory conditions as well as improving the quality of life for the large population of people who suffer from breathing problems,” added Chale. “Being able to contribute your skills and knowledge and then seeing how much your work can improve someone’s outcome and quality of life is very rewarding.”
This week, as we celebrate the contributions of respiratory therapists not only this year, but every year, we invite RTs, their health care colleagues and patients from across the province to reflect upon the difference this group of professionals make every day in the lives of Manitobans. Send us your stories to communications@sharedhealthmb.ca or tag @sharedhealthmb in your posts on social.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
