The Role of Blood Gas Testing and AARC's New Resource

Curious how respiratory therapists can master blood gas testing in an increasingly complex clinical landscape? This episode of the AARC Perspectives podcast features Wendy Gardner, BBA, RRT, and Cindy Raymond Buckley, BSRT, RRT, as they discuss the evolution of blood gas testing and AARC's new microcredential, designed to empower RTs to deliver more precise, confident respiratory patient care.

Learn more about the AARC's new blood gas microcredential. This activity is supported by Siemens Healthcare Diagnostics, Inc.

Thank you for listening! Learn more at aarc.org 

Transcript

Paul Miniter (00:09)

Welcome to today's episode of the AARC Perspectives Podcast. I am Paul Minniter, AARC Vice President of Business Development, and I'm joined by Wendy Gardner, Siemens Healthineers Director of Product Sales, and Cindy Raymond-Buckley, Siemens Healthineers Director of Customer Success for POC. Today, we will be discussing the trajectory and importance of blood gas testing in AARC's new microcredential. This new resource will help RTs learn the latest techniques and strategies for performing and accurately interpreting blood gases to improve patient care. Thanks, Wendy and Cindy, for joining us. To begin, Wendy, can you tell us a little bit more about your background and how your journey to being an RT began?

Wendy Gardner (00:53)

Sure, I've been a respiratory therapist for over 30 years. I worked for 20 years in the clinical setting in a variety of different environments, both pediatric and adult. In one of my last hospital positions, I managed the day-to-day operations of a blood gas laboratory. When I started college, my start into respiratory, I was a science major.

And during that time, I babysat for a lady who was a respiratory therapist working evening shift. And I started reading through her books while she was at work. That initial interest is what piqued me to look more into RT because I didn't know anything about it. And again, that introduction is what started my journey to where I am now.

Paul Miniter (01:40)

Thank you, Cindy. How did you begin your RT career?

Cindy Raymond Buckley (01:43)

Thanks. Yeah, actually becoming an RT was a really natural path for me. So I had asthma when I was seven and by the time I was nine, I was being hospitalized every October, every April with influenza. And so during those hospitalizations, you know, I really developed a strong admiration and appreciation for the respiratory therapists who cared for me. You know, they really played a critical role. not only in my recovery, but also my education and my long-term management of my disease. So those experiences really had a long-lasting impact on me and strongly influenced me to make a decision to pursue it as a career. My personality, I had felt a genuine ⁓ desire to give back, especially with pediatric patients. So I ended up being a neonatal pediatric specialist for the vast majority of my career at the bedside.

Paul Miniter (02:43)

So for both of you, when you think back to those early years as an RT, can you tell us about what was your learning curve with blood gas testing, particularly looking at ⁓ reflecting on learning by doing, your confidence, moments of uncertainty, and interpreting ABGs, and furthermore, the pressure in high acuity settings? Cindy, we'll begin with you.

Cindy Raymond Buckley (03:08)

All right. You know, it's funny academically, the education when you learn how to do blood gas interpretation, it's very structured. In the classroom, you're presented with case studies. They're very controlled and predictable. ⁓ You review the data, you make an interpretation, you arrive at pretty much one straight answer. ⁓ But unfortunately, this really changes. when you get into that clinical environment, you know, as the saying goes, patients don't read the same textbooks. You run a blood gas and the results don't always align with what you initially had expected based on your limited experience. You're required to interpret them in a very high stress situation. There's nothing like having a physician waiting on those immediate results while you're trying to manage multiple variables at one time.

I also think that when I first started, we did a lot more arterial gases and now I feel like we do a very, a big mix of venous and arterial. So it adds another layer of complexity and you make an adjustment to a setting and only to find out that your patient doesn't respond like you anticipated. those experiences are really invaluable.

to learn in the clinical environment. And it really takes that bedside experience to really get that confidence. And those interpretation skills definitely grow with the longer you do it, with the more experiences you come up against. And it really takes progression from a structured learning to a real world scenario.

Paul Miniter (04:52)

Yeah, Wendy, what about you?

Wendy Gardner (04:54)

Yeah, mine was a lot of the same. Putting the theory that you learn in school into clinical practice can be incredibly difficult, especially if it's not one of those easy to interpret blood gases. We've all had a patient that we've taken care of that the blood gas we get doesn't match the clinical presentation that the patient has in front of you. So working with mentors. I started in a teaching institution, not being afraid to ask the questions, ⁓ and time. Just gaining that confidence over time helped tremendously.

Paul Miniter (05:37)

For Cindy, how has the profession changed, especially in relation to blood gas testing, and how can continuing education adapt and keep pace?

Cindy Raymond Buckley (05:48)

Well, goodness, when I first started, blood samples were drawn at the bedside, but then they were placed on ice, and they were sent to a lab for analysis. So as clinicians, we were largely removed from the analytical process itself. We received the results back. but we didn't have direct visibility into a lot of the pre-analytical variables and the potential issues that could affect the test integrity. As the analyzers got smaller, ⁓ we moved them closer to our point of care into stat labs in the patient care units, and of course, directly at the bedside as well with handheld solutions. So the role of respiratory therapists really shifted significantly.

⁓ We became a lot more accountable for device maintenance, for troubleshooting the day-to-day operation. The transition really did give us ⁓ firsthand exposure to pre-analytical errors, ⁓ questionable results, and full testing workflows. It required us to have a much deeper understanding of the analytical process and ultimately its impact on patient care.

⁓ From a competency standpoint, this was a huge change. Early on, I was trained on the analyzer, but I didn't have to go through the yearly competencies. expectations really increased substantially. We became responsible for providing proof of credentials, completing. We had to be aligned to the six elements.

We had to participate in surveys. We had to adhere to all the quality control processes. And so it really put ⁓ a bigger burden on the respiratory therapists to being a lot more versed in all of this. But I think that despite the increase in the expectations, I don't feel like we've had a lot of emphasis on the education. piece in the programs in my experience, I didn't do a lot of blood gas education in school beyond interpretation. We didn't talk about pre-analytics. We didn't learn about CLIA the way the laboratorians had learned about it. So I think that, you know, pre and post-graduation, I think there really is a need for us to be able to constantly be reviewing. things about CLIA, the regulations to make sure that we have opportunities that are focused on making us more well-versed in this to ensure that we are always doing the right thing and that we feel confident in what we're doing at the bedside that we are ultimately focused on supporting good patient quality results.

Paul Miniter (08:42)

Wendy, if you could talk us through a little bit about the point-of-care testing and how it has expanded, especially as it now happens closer at the bedside.

Wendy Gardner (08:53)

Absolutely. As Cindy stated, when I started as an RT to now, it's definitely moved to more bedside or near-patient testing. When I started, again, the ice, everything went in ice and went to the analyzer, which may have been three floors down or three floors up. It all depended on where the lab, because the lab controlled most of what we were doing.

And while our T's are trained in bedside testing, ⁓ there's frequently that lack of formal education in managing the day-to-day for the laboratory. So again, we become experts in interpretation, but do we become experts in what can cause variability in those blood gases? And are we able to recognize those?

That in general leads to not only regulatory, but quality control and documentation issues and potentially treatment issues with some of the patients if it's not interpreted correctly. Now, variability can show up on any of those phases of blood gas testing, whether it's pre-analytical, analytical, or post-analytical. And the RT really is not given. The education for those testing phases. Even all of the pre-analytical issues that can happen, ⁓ not like a med tech, will typically get that. So being able to spot any of the irregularities is key, and having training that helps validate that competency can make a really good RT lab even better.

Now, as we've been discussing, there's been a lag in the evolution of blood gas education, and RTs have needed a more structured approach to showcase their knowledge of this critical respiratory diagnostic tool. With this in mind, ⁓ I had reached out to Siemens Healthineers over a year ago to become a sponsor of this resource. Wendy, can you talk to us about Siemens [Healthineers]' long-term commitment to blood gas testing and

Now, as we've been discussing, there's been a lag in the evolution of blood gas education, and RTs have needed a more structured approach to showcase their knowledge of this critical respiratory diagnostic tool. With this in mind, ⁓ I had reached out to Siemens Healthineers over a year ago to become a sponsor of this resource. Wendy, can you talk to us about Siemens [Healthineers]' long-term commitment to blood gas testing and why your organization decided to sign on?

Wendy Gardner (11:06)

Absolutely. So Siemens [Healthineers] has been in the blood gas testing business for more than 55 years. We were a pioneer in the shift from central laboratory testing to point-of-care solutions. And we've always looked at ways to improve testing as technology has changed. We know because we have a large number of RTs that work with us.

And that we consult with on a daily basis, there have been gaps in education, and we wanted to partner with an organization like the AARC that can help provide that world-class continuing education ⁓ to the entire RT community. It's all about doing the right thing for the patient populations we serve and being able to improve patient care by having a better understanding of blood gas testing from start to finish.

will only strengthen excellence in testing.

Paul Miniter (12:03)

Thank you, and we thank you for that partnership and support. Wendy, can you tell us what the new blood gas microcredential is all about?

Wendy Gardner (12:11)

Absolutely. So it covers the fundamentals of blood gas testing and specimen handling, interpretation, and clinical application. There's quality control and regulatory readiness, point-of-care expansion, and emerging technologies. And then it gets into lab leadership, the things that you have to have for that day-to-day management as well as risk management.

It's going to help in a variety of different areas. For an individual RT, it's going to give them more confidence in interpretation and doing the testing. It's also going to provide formal recognition and help support career growth by having the education. For departments and health systems, it's going to standardize practice. There should be reduced variability with the training that they receive.

It'll help strengthen compliance with regulatory and give everybody a deeper look into what those regulatory requirements are and the why behind those regulatory requirements. For the professional community, it's going to elevate credibility for us, clarify standards that are there again that they may not have gotten in school. And then upon completion,

Learners will get a digital badge to share with employers and others on LinkedIn or their social media of choice and an electronic certificate of completion to showcase their achievement. This credential is going to be good for three years. So from 2026 through 2029, and individuals who take the course will get 15 CRCEs at completion.

Paul Miniter (14:01)

That sounds very robust. if there was something like this that existed when you both started out as an RT, how would it have changed things for you?

Wendy.

Wendy Gardner (14:15)

This certainly would have given me a better understanding when starting my journey in respiratory, not only in the interpretation, but a better understanding of the whys. Why are we doing it this way? Why can different things that we do change the results and how do I identify in those? ⁓ Just the managing the daily, weekly, and monthly requirements of the blood gas testing would have been huge.

Paul Miniter (14:44)

Cindy?

Cindy Raymond Buckley (14:46)

Yeah, definitely for me, I agree the why behind so much understanding better the impacts of the little things I would do while I was obtaining that sample and how I handled it to ensure that I was doing the best thing to get the best patient results would have been great. And as we talked about continuing education, we work in such a dynamic environment, having other opportunities

for continuing education, learning just more about our profession and how we can impact our patients. huge.

Paul Miniter (15:19)

As we conclude, any final thoughts, Wendy?

Wendy Gardner (15:22)

I think this is a great opportunity for clinical advancement and doing more for our patients, more of the right things for our patients.

Paul Minniter (15:35)

Cindy?

Cindy Raymond Buckley (15:36)

Just to partner with the AARC and help all the RTs out there ⁓ that invest so much in the care of their patients.

Paul Minniter (15:47)

Well, thank you, Wendy and Cindy for joining us today for this informative episode of the AARC Perspectives podcast. Please visit aarc.org and search for blood gas microcredential to learn more and purchase this exciting new resource that will help strengthen blood gas excellence across the profession. AARC thanks Siemens Healthineers for their unrestricted educational grant in support of this course.