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LLR-Board of Medical Examiners

Approved by the Board: July 17-18, 2000 Board meeting

Service Area: Licensure, Respiratory Care

Subject: Exemption for Ventilation by Individuals with Proven Competency

POLICY:

South Carolina Code Section 40-47-530(A) states that the South Carolina Respiratory Care Practice Act does not affect certain provisions, including, among others, Aan individual or other health care professional who is licensed by the state or who has proven competency in one or more of the functions included in the definition of Respiratory Care Practice as long as the person does not represent themselves as a Respiratory Care Practitioner. To qualify for this exemption, an individual must provide proof of formal training for the functions which include an evaluation of competence through a mechanism that is determined by the Board and committee to be both valid and reliable. Accordingly, this policy is adopted by the Board and committee to establish an appropriate mechanism for determining an individual's qualification for an exemption under Section 40-47-530(A)(3). Any exemption granted must be limited to the function(s) for which competency has been satisfactorily proven and approved by the Board.

PROCEDURE:

1. Applicant submits a completed application and fee to LLR, Board of Medical

Examiners.

2Staff submits application to Respiratory Care Committee for review.

3. Respiratory Care Committee makes a recommendation to Board of Medical Examiners to grant or deny the application based on its review of the information submitted by the applicant.

4. Board of Medical Examiners grants or denies the application for exemption.

5. Staff notifies the applicant in writing (certified mail, return receipt requested) of the Board's decision concerning the application. The decision may be communicated in a letter from the staff or Office of Disciplinary Counsel (ODC). The letter must advise the applicant that the exemption is strictly limited to the specific function(s) for which the application was approved, and that any other function(s) first must be approved by the Board in a similar manner. If the Board's decision is to deny the application, an Order should be prepared by ODC and served by staff on the applicant by certified mail, return receipt requested. A copy of the notice should be filed in the Board's records, with proof of service (green card or affidavit).

MINIMUM REQUIREMENTS:

An individual exemption may be granted to an applicant who meets the following minimum requirements:

  1. The applicant has proven competency in one or more of the functions included in the definition of the practice of respiratory care. Applicant must provide proof of formal training in the application of artificial pressure adjuncts to the respiratory system in one or more of the following functions:

(a) Set-up, application, troubleshooting and maintenance of artificial pressure adjuncts:

      1. Continuous Positive Airway Pressure (CPAP)
      2. Bi-Level Positive Airway Pressure (BIPAP)
      3. Invasive Mechanical Ventilation (via artificial airway)

(b) Patient assessment and ongoing response to application for artificial pressure adjuncts to the respiratory system

  1. Pulse oximetry
  2. Specimen collection (i.e.; arterial blood gas analysis)
  3. Pulmonary function testing (wearing parameters)

4. Ventilator Settings

5. Exhaled tidal volume

6. Analysis of fraction of inspired oxygen

7. Plan of care

(c) Indications, contra-indications and hazards associated with the application of artificial pressure adjuncts to the respiratory system.

(d) Response to emergencies associated with the application of artificial pressure adjuncts to the respiratory system:

1. Power failure

2. Accidental loss of an artificial airway

3. Equipment failure

2. Individual must submit a copy of the course description including faculty who provided the formal training, dates of attendance, and certification of successful completion of training.

3. Individual must submit proof of initial and ongoing competency assessment in the application of artificial pressure adjuncts to the respiratory system. An original certification, certified training, or original letter on letterhead from the appropriate representative of the organization verifying that the applicant attended and successfully completed the training must be submitted.

4. Individual must submit information regarding anticipated employment responsibilities and employment setting.