Life Support

Course Description

Life Support is the advanced critical care course of the respiratory care curriculum. It covers the procedures and monitoring used in the management of the acutely and critically ill patient: chest tube maintenance and vacuum systems, nasogastric and orogastric tube placement and maintenance, chest radiography, cardiopulmonary stress testing, and hemodynamic monitoring including cardiac catheterization and intra-aortic balloon counterpulsation. It also addresses advanced life support protocols, therapeutic hypothermia, critical care pharmacology, and the integrated management of the acutely ill patient.

Within the SCNS taxonomy, RET is the Respiratory Care prefix. This course sits near the end of the associate-degree sequence, after mechanical ventilation and alongside or immediately before the final clinical rotations. It appears at approximately five Florida institutions. Daytona State publishes it at 3 credits and offers it in summer.

This is the course that separates a therapist who can run a ventilator from a therapist who can function in an intensive care unit. The content is broad and the reasoning demand is high: the point is not to memorize procedures but to integrate hemodynamic, ventilatory, and pharmacologic data into a coherent picture of a deteriorating patient.

⚠ Number and title cautions — both are unusually unreliable here

Two distinct problems attach to this number, and both can produce a wrong equivalency decision.

The C suffix. Florida course inventories carry this course as RET2244C, implying an integrated lecture-and-laboratory course. Daytona State and Valencia College both publish it as RET2244 without the C suffix — a 3-credit lecture course (Valencia lists it explicitly as 3-0-0). Neither Broward College nor Gulf Coast State carries the number at all. Students and evaluators should verify the exact number, suffix, and credit value on the institution's own catalog page. Where an institution does use the C-suffixed form, expect an integrated laboratory component and a correspondingly higher contact-hour total (approximately 60 rather than 45).

The title. Daytona State titles this course "Life Support." Valencia titles the same number "Advanced Life Support." That would be a harmless variation except that Daytona State separately offers RET4245 "Advanced Life Support" — a distinct, upper-division, 4000-level course in its B.S. track. A student, advisor, or transfer evaluator matching on the title "Advanced Life Support" could easily conflate a second-year associate course with a fourth-year baccalaureate course. Match on the number and the catalog description, never on the title.

Learning Outcomes

Required Outcomes

• Describe the indications, insertion, management, and troubleshooting of chest tubes and pleural drainage systems.
• Explain the operation of water-seal and dry-suction chest drainage units and recognize an air leak, a tension pneumothorax, and a malfunctioning system.
• Describe the placement, verification, and maintenance of nasogastric and orogastric tubes and the respiratory implications of each.
• Interpret chest radiographs for line and tube placement, pneumothorax, effusion, atelectasis, consolidation, and pulmonary edema.
• Describe the principles, indications, and contraindications of cardiopulmonary stress testing and the therapist's role in it.
• Explain hemodynamic monitoring: arterial lines, central venous pressure, pulmonary artery catheters, and derived parameters.
• Interpret hemodynamic values and waveforms and integrate them with ventilatory and oxygenation data to characterize a shock state.
• Describe cardiac catheterization, its indications, and post-procedure respiratory considerations.
• Explain intra-aortic balloon counterpulsation: physiologic rationale, timing, indications, and complications.
• Describe advanced cardiac life support algorithms and the respiratory therapist's specific responsibilities during a resuscitation.
• Manage the airway during resuscitation: bag-mask ventilation, adjuncts, intubation assistance, and confirmation of placement.
• Describe targeted temperature management (therapeutic hypothermia) after cardiac arrest and its respiratory implications.
• Describe the pharmacology of vasoactive agents, antiarrhythmics, sedatives, analgesics, and neuromuscular blocking agents used in critical care.
• Integrate assessment, monitoring, ventilation, and pharmacologic data to formulate and justify a plan of care for a critically ill patient.
• Communicate deterioration and recommend interventions to the critical care team using protocol-driven language.

Optional Outcomes

• Describe extracorporeal membrane oxygenation (ECMO), its indications, and the therapist's role.
• Describe advanced and rescue ventilation modes, including APRV and high-frequency ventilation.
• Describe prone positioning and adjunctive therapies in ARDS.
• Describe point-of-care ultrasound applications in critical care.
• Describe ventricular assist devices and advanced mechanical circulatory support.
• Describe end-of-life care, terminal extubation, and the therapist's role in goals-of-care conversations.

Major Topics

Required Topics

• Pleural anatomy and physiology; pneumothorax, hemothorax, and effusion
• Chest tubes, pleural drainage systems, vacuum systems, and troubleshooting
• Nasogastric and orogastric tubes: placement, verification, and complications
• Chest radiography: systematic interpretation, line and tube position, common pathology
• Cardiopulmonary exercise and stress testing
• Hemodynamic monitoring: arterial, central venous, and pulmonary artery catheters
• Waveform analysis, derived parameters, cardiac output, and oxygen delivery and consumption
• Shock states: hypovolemic, cardiogenic, distributive, obstructive — recognition and differentiation
• Cardiac catheterization and coronary intervention
• Intra-aortic balloon pump physiology, timing, and complications
• Advanced cardiac life support algorithms and team roles
• Airway management during resuscitation
• Post-arrest care and targeted temperature management
• Critical care pharmacology: vasopressors, inotropes, antiarrhythmics, sedation, analgesia, paralytics
• Integrated critical care management and clinical decision making
• Documentation, protocols, and therapist-driven protocol practice

Optional Topics

• ECMO and extracorporeal support
• Advanced and rescue ventilation modes; ARDS management
• Point-of-care ultrasound
• Ventricular assist devices
• Transport of the critically ill patient
• End-of-life care and terminal weaning
• Rapid response and medical emergency teams

Resources & Tools

• Egan's Fundamentals of Respiratory Care — carried forward from earlier courses; its critical care and hemodynamics chapters are core here.
• Pilbeam's Mechanical Ventilation — the standard ventilation text, used alongside this course's monitoring content.
• Cardiopulmonary Anatomy and Physiology (Des Jardins) — the reference for the physiology this course assumes.
• AARC Clinical Practice Guidelines — the profession's standard-of-care documents, free.
• American Heart Association — current ACLS provider materials and the periodically updated resuscitation guidelines. Note that these are revised on a defined cycle; use the current edition.
• NBRC content outlines for the TMC and, especially, the Clinical Simulation Examination — this course maps more directly onto the CSE than any other in the program.
• Simulation laboratory: high-fidelity manikins, hemodynamic monitoring simulators, chest drainage units, ventilators, and code carts.
• Case-based clinical simulation software for CSE-format practice.

Career Pathways

• Critical care respiratory therapist — adult ICU, surgical ICU, cardiovascular ICU; the direct destination of this course.
• Adult Critical Care Specialist (ACCS) — the NBRC specialty credential built on exactly this content.
• Rapid response and code team therapist — hospital-wide emergency response roles.
• ECMO specialist — a highly compensated specialty available at Florida's larger academic and cardiac centers.
• Transport therapist — ground and air critical care transport.
• Cardiovascular and pulmonary diagnostics — stress testing laboratories and cardiac catheterization support.
• Clinical educator or clinical specialist — often the next step for therapists who excel in this material.
• Florida's cardiac and critical care volume is concentrated in the large systems — Tampa General, AdventHealth Orlando, Orlando Health, Baptist Jacksonville, UF Health, Cleveland Clinic Florida, Lee Health, and the HCA Florida network. SOC code 29-1126 Respiratory Therapists.

Special Information

⚠ This course does not give you an ACLS card

A recurring and expensive misunderstanding. This course teaches the content of advanced cardiac life support — the algorithms, the pharmacology, the physiology, and the therapist's role. It does not confer American Heart Association ACLS provider certification, which is a separate course with its own written and megacode testing, its own fee, and a two-year renewal cycle.

Nearly every Florida hospital requires a current AHA BLS card for any patient-contact role and a current ACLS card for critical care assignment; many programs require both before clinical rotations begin, and some require PALS or NRP as well. Budget the time and the money, and track the expiration dates — a lapsed card can remove a therapist from the schedule.

⚠ Hemodynamics is the hardest content in the program, and it is heavily tested

Students consistently underestimate hemodynamic monitoring. It is the material with the highest conceptual load in the associate curriculum: preload, afterload, contractility, and their derived indices interact, and the numbers only mean something in combination. A single value — a low cardiac output, a high wedge pressure — is diagnostic of nothing on its own.

It is also the content that dominates the NBRC Clinical Simulation Examination, the second examination on the path to RRT. The CSE presents branching patient scenarios that require gathering the right data and then acting on it, which is precisely the reasoning this course builds. Students who memorize normal ranges without understanding the physiology pass the multiple-choice portion and struggle on the simulations. Work the cases; do not study the tables.

⚠ Scope and protocol practice: knowing what you may recommend versus what you may do

Respiratory therapists in Florida practice under Chapter 468, Part V, Florida Statutes, administered by the Florida Board of Respiratory Care. Much of critical care respiratory practice runs on therapist-driven protocols — standing orders that authorize the therapist to assess a patient and adjust therapy within defined limits without a new physician order for each change. Protocols are institution-specific and are approved by that institution's medical staff.

The distinction students must carry into clinical: a protocol authorizes what it says and nothing more. Acting outside a protocol, however clinically reasonable, is practicing outside the order — and the therapist, not the physician, owns that decision. The correct move when the protocol does not cover the situation is to recommend, clearly and specifically, and get the order. Learning to make a crisp, justified recommendation to an intensivist is a genuine professional skill and it is what this course is preparing students to do.

Credits, contact hours, and institutional variation

The values reported here — 3 credits and approximately 45 contact hours — reflect the two Florida catalogs that publish this course explicitly: Daytona State (3 credits, lecture) and Valencia (3 credits, 3-0-0 lecture, 0 lab, 0 clinical). They are also consistent with the related lecture-only RET course in this repository, RET2350 Cardiopulmonary Pharmacology, at 3 credits and 45 hours. Where an institution offers the C-suffixed form with an integrated laboratory, expect approximately 60 contact hours instead. Confirm on the institution's own catalog page.

How Florida course levels affect transfer

The first digit of an SCNS number denotes the year of offering, not transferability. Courses at the 1000 and 2000 levels transfer transparently between Florida public institutions; 3000 to 4000 is also unproblematic, since both are upper division. The boundary that actually matters is 2000 to 3000, where lower-division credit generally cannot satisfy an upper-division requirement — relevant to respiratory care because several Florida institutions now offer a B.S. completion track with 3000- and 4000-level RET courses, and associate-level coursework does not substitute for those.

One practical caveat overrides all of the above in respiratory care: programs are accredited, lock-step cohorts with sequenced clinical placements, and they accept transfer into the professional sequence rarely and only case by case. A student moving between programs should expect to repeat coursework regardless of what SCNS says, and should get any transfer evaluation in writing before relying on it.