Two-Person Tasks: Prioritizing Patient Safety in Respiratory Therapy

Seasoned respiratory therapists often develop the skill and confidence to manage complex procedures single-handedly, even tasks traditionally requiring multiple people. However, there are critical moments when having an extra set of hands is not just helpful but necessary to ensure patient safety—particularly when performing tasks that may compromise the patient’s airway or ventilation.

1. Changing Trach Ties or Endotracheal Tube Holders

When changing trach ties or an endotracheal tube (ETT) holder, the patient’s airway must remain securely held at all times. Without proper stabilization, even a brief moment of unsecured support can lead to complications such as decannulation or accidental extubation, especially if the patient coughs. A second person should always be present to hold the airway in place while you complete the securing process. The risk of airway compromise far outweighs the convenience of completing the task alone.

2. Changing the Ventilator Circuit

Ventilator circuit changes are routine but not without risk. While most changes occur without issue, a faulty circuit or unexpected leak can quickly compromise a patient’s ventilation. To mitigate this risk, having a partner bag the patient allows you to focus on carefully changing the circuit and conducting a thorough circuit check. This ensures ventilation and oxygenation remain uninterrupted throughout the process.

Best Practices for Airway Management

• Ambu Bag Readiness: Always have an Ambu bag turned on with a mask readily available at the head of the bed. In emergencies, every second counts, and immediate access to resuscitation equipment can make the difference.

• Communicate with Nursing Staff: If assistance is unavailable, inform the bedside nurse before starting the procedure. Ideally, the nurse should be present or nearby to provide support if needed.

In respiratory therapy, efficiency and independence are valuable, but patient safety must always come first. Recognizing when to involve another team member is a hallmark of a skilled and conscientious therapist. A patient’s survival and quality of life depend on maintaining stable ventilation and oxygenation. Always consider this when deciding whether to proceed alone or request assistance.