<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.32.11.09" title_num="10" subtitle_num="32" chapter_num="11" heading="Scope of Practice, Identification, and Change in Name or Address.">
  <paragraph num="A.">
    <text>A respiratory care practitioner may practice only under the supervision of and in collaboration with a physician.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The practice of respiratory care includes the following:</text>
    <paragraph num="(1)">
      <text>Direct and indirect respiratory care services that are safe, aseptic, preventive, and restorative to the patient;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The practice of the principles, techniques, and theories derived from cardiopulmonary medicine;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Evaluation and treatment of individuals whose cardiopulmonary functions have been threatened or impaired by developmental defects, the aging process, physical injury, disease, or actual or anticipated dysfunction of the cardiopulmonary system;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Observation and monitoring of physical signs and symptoms, general behavior, and general physical response to respiratory care procedures, and determination of whether initiation, modification, or discontinuation of the treatment regimen is warranted;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The transcription and implementation of a written or oral order, or both, pertaining to the practice of respiratory care;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Evaluation techniques including cardiopulmonary functional assessments, gas exchange, the need and effectiveness of therapeutic modalities and procedures, and assessment and evaluation of the need for extended care and home care procedures, therapy, and equipment;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Professional application of techniques, equipment, and procedures involved in the administration of respiratory care such as:</text>
      <paragraph num="(a)">
        <text>Therapeutic and diagnostic gases (excluding general anesthesia);</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Prescribed medications for inhalation or direct tracheal instillation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The administration of prescribed analgesic agents including substances listed in Schedule IV as defined in Criminal Law Article, §5-405, Annotated Code of Maryland, by subcutaneous injection or inhalation for the performance of respiratory care procedures;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Nonsurgical intubation, maintenance, and extubation of artificial airways;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Advanced cardiopulmonary measures;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Chest needle decompression;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Cardiopulmonary rehabilitation;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Mechanical ventilation or physiological life support systems;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Collection of body fluids and blood samples for evaluation and analysis, including collection by intraosseous access;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Insertion of diagnostic arterial access lines, including large bore intravenous access; and</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Collection and analysis of exhaled respiratory gases;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>The clinical supervision of licensed respiratory care practitioners, respiratory care departments, or the provision of any respiratory care services; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>The respiratory care clinical instruction or oversight of respiratory care students, while performing respiratory care procedures as part of their clinical curriculum.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A respiratory care practitioner shall wear an identification tag or a badge which identifies that individual as a respiratory care practitioner.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Change in Name or Address.</text>
    <paragraph num="(1)">
      <text>Within 60 days after the change, a licensee shall notify the Board in writing of a change in name or address.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Licensees who fail to notify the Board of name or address changes as required by §D(1) of this regulation are subject to an administrative penalty of $100.</text>
    </paragraph>
  </paragraph>
</regulation>