Respiratory therapists (RTs) are healthcare professionals who specialize in the assessment, treatment, and management of patients with breathing disorders and cardiopulmonary conditions. They treat patients with asthma, chronic obstructive pulmonary disease (COPD), pneumonia, cystic fibrosis, sleep apnea, acute respiratory distress syndrome (ARDS), and respiratory failure. RTs manage mechanical ventilators for critically ill patients in intensive care units, administer inhaled medications and aerosol treatments, perform arterial blood gas analysis, conduct pulmonary function testing, assist with intubations and airway management, provide oxygen therapy, and educate patients on managing chronic respiratory conditions. The COVID-19 pandemic brought unprecedented attention to respiratory therapy, as RTs were among the most critical frontline providers managing patients with severe respiratory failure.
Education Pathway
Associate Degree (2 years): An associate degree in respiratory therapy from a CoARC-accredited program is the minimum educational requirement for entry into the profession. Associate programs include coursework in anatomy, physiology, pharmacology, cardiopulmonary pathology, mechanical ventilation, patient assessment, and clinical rotations in hospitals and other healthcare settings. Bachelor’s Degree (4 years): An increasing number of RTs pursue a bachelor’s degree in respiratory therapy (BSRT), which provides additional coursework in research, leadership, management, patient education, and evidence-based practice. The BSRT is becoming the preferred degree for career advancement, and the professional organization (AARC) has recommended the baccalaureate as the entry-level degree, though the associate degree remains the current minimum. Licensure: After graduation, you must pass the Therapist Multiple-Choice (TMC) Examination to earn the Certified Respiratory Therapist (CRT) credential, and the Clinical Simulation Examination (CSE) to earn the Registered Respiratory Therapist (RRT) credential. The RRT is the preferred credential for most employers. State licensure is also required in most states.
What RTs Do
Critical Care: RTs in intensive care units manage mechanical ventilators for patients who cannot breathe independently due to respiratory failure, ARDS, sepsis, trauma, or post-surgical complications. Ventilator management involves setting and adjusting ventilator parameters (tidal volume, respiratory rate, PEEP, FiO2), monitoring patient-ventilator interaction, performing weaning trials (gradually reducing ventilator support as the patient recovers), and troubleshooting equipment alarms and complications. Critical care RTs work closely with physicians, nurses, and other team members to optimize respiratory care for the sickest patients in the hospital. This is one of the most challenging and rewarding areas of respiratory therapy practice.
Emergency Department and Rapid Response: RTs respond to respiratory emergencies throughout the hospital, including cardiac arrests (providing airway management and ventilation during resuscitation), acute asthma exacerbations, anaphylaxis, and acute respiratory failure. They also participate in rapid response teams that are called when hospitalized patients show signs of clinical deterioration. The emergency and rapid response role requires composure under pressure, quick clinical decision-making, and advanced procedural skills.
Pulmonary Diagnostics: RTs perform pulmonary function tests (spirometry, lung volumes, diffusion capacity) that diagnose and monitor conditions like asthma, COPD, and interstitial lung disease. They also perform arterial blood gas (ABG) analysis, which measures the levels of oxygen, carbon dioxide, and acid-base balance in the blood, providing critical information for managing respiratory and metabolic conditions. Neonatal and Pediatric Care: RTs who work in neonatal intensive care units (NICUs) manage mechanical ventilation and respiratory support for premature infants and newborns with respiratory distress. Neonatal respiratory care requires specialized skills due to the unique physiology of premature lungs and the precision required when managing tiny patients. Outpatient and Home Care: RTs in outpatient settings provide disease management education for patients with asthma, COPD, and sleep apnea, perform pulmonary rehabilitation (exercise training and education for patients with chronic lung disease), and manage home ventilator and oxygen therapy programs.
Salary and Job Outlook
The median annual salary for respiratory therapists is approximately $77,960 according to the Bureau of Labor Statistics. Salaries range from approximately $55,000 for entry-level positions to $100,000+ for experienced RTs in critical care, management, or high-cost geographic areas. The profession is projected to grow 13 percent through 2032, faster than average, driven by the aging population’s increasing incidence of chronic respiratory disease, the expanded recognition of RTs as essential providers after the COVID-19 pandemic, and the growing role of RTs in disease management and pulmonary rehabilitation. The educational investment is relatively modest (associate degree tuition of $10,000 to $30,000; bachelor’s programs of $30,000 to $80,000), making the return on investment among the strongest in healthcare.
Advantages and Challenges
Advantages: Relatively short and affordable training (2 to 4 years), strong job demand, the critical importance of the work (every patient needs to breathe, and RTs are the experts in making that happen), diverse practice settings, the adrenaline and satisfaction of emergency and critical care work, shift-based scheduling (which provides days off during the week), and the growing scope of practice that is expanding RTs’ roles and autonomy.
Challenges: Exposure to infectious respiratory diseases (including tuberculosis, influenza, and COVID-19), the emotional toll of caring for critically ill and dying patients (particularly in the ICU and NICU), the physical demands of 12-hour shifts with long periods of standing, the relatively lower salary ceiling compared to professions with longer training pathways, and the shift work (nights, weekends, and holidays are standard in hospital settings).
Getting Started
Middle school: Explore science and learn about the respiratory system. High school: Take biology and chemistry, volunteer in hospitals, and learn about cardiopulmonary care. Undergraduate: Enroll in a CoARC-accredited respiratory therapy program (associate or bachelor’s), complete clinical rotations, pass the TMC and CSE exams, and earn the RRT credential.
Advanced Practice and Expanded Roles: The respiratory therapy profession is evolving toward greater clinical autonomy and expanded scope of practice. In many hospitals, experienced RTs function as therapist-driven protocol practitioners, independently assessing patients and making treatment decisions (adjusting bronchodilator therapy, titrating oxygen, managing non-invasive ventilation, initiating weaning protocols) based on established protocols without requiring individual physician orders for each intervention. This protocol-based practice model improves efficiency, reduces delays in treatment, and leverages the RT’s specialized expertise. Some states have established advanced practice respiratory therapist credentials or are exploring legislation that would formalize the expanded RT role. The profession is also moving toward requiring a bachelor’s degree as the entry-level credential, which would align respiratory therapy with other allied health professions that have undergone similar educational upgrades (physical therapy, occupational therapy, audiology).
Sleep Medicine: Respiratory therapists play an important role in sleep medicine, conducting polysomnography (sleep studies) that diagnose sleep disorders including obstructive sleep apnea (OSA), central sleep apnea, and other conditions. RTs who specialize in sleep medicine set up and monitor overnight sleep studies, titrate continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) devices, educate patients on the use and maintenance of sleep therapy equipment, and work with sleep medicine physicians to manage complex sleep-disordered breathing. Sleep medicine offers RTs a practice area with regular hours (sleep studies are conducted at night, but many sleep labs employ daytime staff for patient education, equipment setup, and data analysis), growing demand (OSA is increasingly recognized as a major public health concern linked to cardiovascular disease, diabetes, motor vehicle accidents, and cognitive impairment), and the satisfaction of dramatically improving patients’ quality of life through effective sleep therapy.
Education and Leadership: Experienced RTs can advance into roles as respiratory therapy department managers (overseeing staffing, budgets, and quality metrics for hospital respiratory care departments), clinical educators (training new therapists and medical residents in respiratory procedures and ventilator management), program directors (leading respiratory therapy educational programs at colleges and universities), and quality improvement specialists (analyzing respiratory care outcomes and implementing evidence-based protocols to improve patient care). These advancement paths typically require a bachelor’s or master’s degree and several years of clinical experience.
References
Bureau of Labor Statistics. “Respiratory Therapists.” BLS, 2025. https://www.bls.gov/ooh/healthcare/respiratory-therapists.htm. Accessed March 2026.