Pediatric and Neonatal Respiratory Care

Course Description

RET2714C – Pediatric and Neonatal Respiratory Care is a 4-credit lecture-and- laboratory course in Florida's Respiratory Care A.S. curriculum, taken in the second year. It covers the respiratory care of newborns and children — patients whose anatomy, physiology, and disease processes differ from adults enough that adult practice transfers poorly and, applied unmodified, causes harm.

The physiological differences drive everything. Neonates have small airways with disproportionately high resistance, compliant chest walls, limited respiratory reserve, and immature surfactant production in the premature. They desaturate fast. Equipment sized for adults does not fit and pressures safe for adults are not safe for them. The course teaches that reasoning explicitly rather than asking students to memorize different numbers.

Content covers fetal and neonatal cardiopulmonary development and the transition to extrauterine life; assessment of the newborn including Apgar scoring and gestational age assessment; neonatal disease — respiratory distress syndrome, meconium aspiration, transient tachypnea, persistent pulmonary hypertension, and bronchopulmonary dysplasia; pediatric disease — asthma, bronchiolitis, croup, epiglottitis, cystic fibrosis, and congenital heart disease; and the modalities: oxygen delivery, CPAP, conventional and high-frequency ventilation, surfactant administration, nitric oxide, and ECMO awareness.

Neonatal transport and stabilization of the acutely ill newborn are specifically covered, reflecting the regional referral structure of neonatal care.

Offered at approximately 21 Florida institutions with accredited respiratory care programs, including Broward, College of Central Florida, Daytona State, Eastern Florida State, Florida State College at Jacksonville, Florida SouthWestern, Gulf Coast State, Hillsborough, Indian River State, Lake-Sumter, Miami Dade, Pensacola State, Santa Fe, St. Johns River, St. Petersburg, Seminole State, Tallahassee State, and Valencia.

Learning Outcomes

Required Outcomes

• Describe fetal cardiopulmonary development and the physiological transition at birth.
• Explain the anatomic and physiologic differences between neonatal, pediatric, and adult patients and their clinical implications.
• Perform newborn assessment including Apgar scoring and gestational age estimation.
• Describe the etiology, presentation, and management of major neonatal respiratory diseases.
• Describe the etiology, presentation, and management of major pediatric respiratory diseases.
• Select and apply oxygen delivery devices appropriate to neonatal and pediatric patients.
• Describe indications, setup, and monitoring of CPAP and noninvasive support in these populations.
• Describe conventional and high-frequency ventilation strategies and their indications.
• Describe surfactant replacement and inhaled nitric oxide therapy.
• Interpret blood gas values in neonatal and pediatric patients and recommend appropriate changes.
• Participate in neonatal resuscitation consistent with current NRP guidelines.
• Describe neonatal transport considerations and stabilization prior to transfer.
• Apply age-appropriate communication with pediatric patients and their families.

Optional Outcomes

• Describe ECMO indications and the respiratory therapist's role.
• Describe congenital heart disease and its respiratory implications.
• Describe home care and long-term ventilation for pediatric patients.
• Describe pediatric sleep-disordered breathing.
• Prepare for the NPS (Neonatal/Pediatric Specialty) credential.
• Describe ethical considerations at the limits of viability.

Major Topics

Required Topics

• Fetal and neonatal development — lung development, surfactant, fetal circulation, and transition at birth.
• Anatomic and physiologic differences — airway size and resistance, chest wall compliance, and respiratory reserve.
• Newborn assessment — Apgar, gestational age, physical examination, and monitoring.
• Neonatal respiratory disease — RDS, meconium aspiration, TTN, PPHN, apnea of prematurity, and BPD.
• Pediatric respiratory disease — asthma, bronchiolitis, croup, epiglottitis, pneumonia, cystic fibrosis, and foreign body aspiration.
• Oxygen therapy — delivery devices, hoods, cannulas, blending, and oxygen toxicity including retinopathy of prematurity.
• Noninvasive support — CPAP, NIPPV, and high-flow nasal cannula.
• Mechanical ventilation — conventional strategies, volume and pressure targeting, and high-frequency oscillatory and jet ventilation.
• Pharmacologic therapy — surfactant, inhaled nitric oxide, bronchodilators, and aerosol delivery in small patients.
• Blood gas interpretation — age-specific normal values and clinical decision-making.
• Neonatal resuscitation — NRP algorithm and the therapist's role in the delivery room.
• Neonatal transport — stabilization, equipment, and the regional referral system.
• Family-centered care — communication with parents and age-appropriate interaction with children.

Optional Topics

• ECMO and advanced life support.
• Congenital heart disease.
• Pediatric home care and long-term ventilation.
• Sleep-disordered breathing in children.
• Ethics at the limits of viability and end-of-life care.
• NPS credential preparation.

Resources & Tools

• Neonatal and Pediatric Respiratory Care (Walsh), Elsevier — the standard text for this course.
• Perinatal and Pediatric Respiratory Care (Czervinske & Barnhart) — a common alternative.
• Egan's Fundamentals of Respiratory Care, Elsevier — the general reference across the curriculum.
• American Academy of Pediatrics / American Heart Association Neonatal Resuscitation Program (NRP) — many programs require NRP certification.
• PALS (Pediatric Advanced Life Support) — frequently required alongside NRP.
• American Association for Respiratory Care (AARC) — clinical practice guidelines.
• NBRC — credentialing body; content outlines for the TMC, CSE, and NPS examinations.
• Laboratory equipment — neonatal and pediatric ventilators, CPAP systems, infant simulators, and blenders.
• Clinical rotation in a NICU or PICU, arranged through the program.

Career Pathways

• Respiratory Therapist (SOC 29-1126) — the core occupation; hospitals, NICUs, PICUs, and transport teams.
• Neonatal/Pediatric Specialist — therapists holding the NBRC NPS credential, typically working in Level III and IV NICUs.
• Neonatal Transport Team member — a specialized role this course directly prepares for.
• Pediatric Home Care Therapist — supporting ventilator-dependent children at home.
• Clinical Educator and Program Faculty — requiring additional education.
• Pulmonary Function and Sleep Technologist — related pathways with separate credentials.

Florida employers include the children's hospitals and NICU-capable systems: Johns Hopkins All Children's in St. Petersburg, Nemours Children's in Orlando and Jacksonville, AdventHealth for Children, Wolfson Children's in Jacksonville, Nicklaus Children's in Miami, Golisano Children's in Fort Myers, and Tampa General. Neonatal transport teams operate regionally across the state.

Special Information

Credit variation across Florida — check locally

Credit values differ. Lake-Sumter State College lists RET2714C at 4 credits as a lecture/laboratory course, and Polk State lists 4; Broward and Florida SouthWestern list RET2714 at 3 credits. The course also appears as both RET2714 and RET2714C, the C form indicating the integrated laboratory. Titles vary too: Pediatric and Neonatal Respiratory Care, Pediatric/Neonatal Respiratory Care, Neonatal-Pediatric Respiratory Care, and Seminole State's Pediatric Respiratory Care. Students transferring between Florida respiratory care programs should confirm the credit value, and program directors should compare contact hours rather than credit counts.

Prerequisites

Admission to the respiratory care program is the universal requirement, and these programs are limited-access and competitive. Course-level prerequisites are program-sequence based: Lake-Sumter requires a grade of C or higher in RET1875L, and most programs require the preceding cardiopulmonary and mechanical ventilation coursework. Programs typically also require immunizations, background check, drug screening, and healthcare provider BLS before clinical placement. Verify locally.

Credentialing

Graduates of a CoARC-accredited program are eligible for the NBRC examinations leading to the RRT credential. Florida additionally requires state licensure through the Department of Health Board of Respiratory Care to practice — a legal requirement distinct from NBRC credentialing. The Neonatal/Pediatric Specialty (NPS) credential is a separate post-RRT examination that this course directly supports; NICU employers often prefer or require it.

Position in the curriculum

This is a second-year course following cardiopulmonary anatomy and physiology, respiratory therapeutics, and mechanical ventilation, and it runs alongside or before the advanced clinical practicum. Its content is represented on the NBRC examinations and is the foundation for the NPS.

The clinical reality is demanding

Two things worth telling students plainly. First, margin for error is small: dosing, pressures, and equipment sizing are weight-based and a decimal error in a 900-gram patient has immediate consequences. Programs drill calculation for that reason. Second, neonatal and pediatric critical care is emotionally demanding work — students will encounter infant death during clinical rotations. Programs generally address this directly and provide support resources, and it is a reasonable factor for a student to weigh when choosing a specialty.