RRT-ACCS study guide
RRT-ACCS · Work through your exam, one topic at a time.
The Registered Respiratory Therapist – Adult Critical Care Specialist (RRT-ACCS) is a specialty credential offered by the National Board for Respiratory Care (NBRC), which lists the Adult Critical Care Specialist credential alongside its entry-level and other specialty credentials. It is designed for respiratory therapists who practice with critically ill adult patients - intensive care units, high-acuity step-down units, and emergency or transport settings - and who want to demonstrate knowledge beyond entry-level practice. The exam is organized around three content areas: patient assessment and monitoring; initiation and modification of respiratory care; and quality, safety, and professional practice in adult critical care. Questions test clinical judgment in ventilator management, oxygenation and ventilation strategies, hemodynamic and respiratory monitoring, airway care, and the safety and systems thinking that surround those decisions. The RRT-ACCS study guide has 3 sections and about 966 words.
01Patient Assessment and Monitoring in Adult Critical Care
Assessment in the ICU is a synthesis of gas exchange, respiratory mechanics, and hemodynamics. Interpret ABGs in a fixed order: pH, then PaCO2 and HCO3, then check whether compensation is appropriate, then calculate the anion gap.
311 words, about 2 min02Initiation and Modification of Respiratory Care
Initiation is about matching mode and settings to physiology and to a stated goal. Know volume control, pressure control, SIMV, PRVC, and APRV at a conceptual level, and know that lung-protective ventilation means 6 mL/kg predicted body weight, plateau 30 cmH2O or less, driving pressure 15 or less, and FiO2/PEEP titrated to a target saturation.
341 words, about 2 min03Quality, Safety, and Professional Practice in Adult Critical Care
Quality and safety in the adult ICU center on preventable harm bundles: ventilator-associated event prevention (head of bed 30-45 degrees, sedation interruption paired with breathing trials, oral care, DVT and stress ulcer prophylaxis, cuff pressure monitoring, early mobility), plus CLABSI and CAUTI bundles and hand hygiene. Know the surveillance language: VAC, IVAC, and PVAP under the VAE umbrella, and that these are surveillance definitions rather than clinical diagnoses.
314 words, about 2 min