It’s closing time and the critical care unit is busy


The Critical Care Unit of any hospital is an intense workplace environment for all healthcare professionals-for a lot of reasons. The number of patients and the variety and severity of a person’s condition contribute to the “critical” circumstances that is par for the course in critical care.

Respiratory Therapists working in critical care just about see it all. If a patient cannot breathe on their own they require ventilation. A Respiratory Therapist stays with the patient all the way, while they are being transported to X-ray or going for a CAT scan. “RTs are required to stabilize the artificial airway tube that leads to the lungs and monitor the patient during ventilation,” said Bernie McNamara, a Respiratory Therapists at Hamilton General Hospital.”

Hamilton General is a feeder hospital for trauma victims in the outlying areas of Guelph, Cambridge, Kitchener, Simcoe and North Bay. For two whole days during the SARS Crisis, Hamilton General was the trauma centre for all of Ontario.

A common cause of trauma is car accidents and although there is not a particular season that is worse than another, there seems to be a bewitching couple of hours. “Friday and Saturday nights can be real nail biters,” said McNamara. “Bar closing time does have an impact on trauma admissions to critical care and the worst time is between 2:00 am and 4:00 am.”

Unfortunately, in critical care, not many patients remember meeting the Respiratory Therapist. That is because when RTs are called, the patients are usually both critical and unconscious.

McNamara jokes, “I guess in some ways, you really don’t want to know who we are.”

“You don’t see miraculous recoveries everyday in critical care -but when you do, you don’t forget them. I’ve seen people with major brain injuries that you would swear would never be able to breathe on their own again. And then you see them walking in with their families to say thanks for what the health care team did for them,” said McNamara.

Part of what McNamara enjoys about working in a Critical Care Unit is the ability to use different areas of respiratory therapy training. One of the additional areas of his training is in Hyperbaric Oxygen Therapy. He gained this expertise through a course offered in North Carolina, USA.

Hyperbaric Oxygen Therapy is used in some cases to increase the delivery of oxygen under pressure to a patient. This therapy has been proven to reduce the long-term effects of smoke inhalation and may also speed up healing time, explained McNamara.

Of the approximately 2,200 Respiratory Therapists in Ontario and 70% work in acute/critical care.