Professional Practice Assumptions

It is expected that all Respiratory Therapists (RTs) in Ontario possess the entry to practice competencies (i.e., knowledge, skills and judgment/abilities) to make sound clinical decisions regarding administration of oxygen (O2) therapy as part of their education and clinical experience. In addition, the College assumes that all Members:


Possess a specialized body of knowledge (e.g., about oxygen therapy);


Are committed to maintaining a high standard of professional practice through self- governance;


Are committed to lifelong learning and the development of knowledge, skills and abilities throughout their career;

Are committed to ongoing professional development;
Are committed to the principle of accountability in their professional practice; and
Are committed to practicing in an ethical manner.

In addition, Members are expected to act only within their professional scope of practice and in the best interest of their patients/clients. Please refer to the CRTO Standards of Practice and the Interpretation of Authorized Acts Professional Practice Guideline.

The purposes of this CBPG are to:


Provide a framework for Respiratory Therapists to make informed patient care decisions about oxygen therapy that are safe and ethical;


Provide a framework for clinical best practices regarding oxygen therapy that are current, evidence based and linked to up-to-date resources and learning materials;


Support Respiratory Therapists in the maintenance of competency, support ongoing professional development and quality practice; and


Provide the public and other health care professionals with confidence that Respiratory Therapists are safe and ethical regulated health care professionals with the expertise to administer oxygen therapy that results in positive health care outcomes for the public of Ontario.

Self-Regulation < > Self-Governance

Guiding Principles

Therapeutic oxygen should only be administered by competent healthcare providers who possess the required competencies (knowledge, skill, and judgment/abilities) to make clinical decisions regarding the administration of oxygen. The administration of substances by inhalation is a controlled act under the Regulated Health Professions Act (RHPA) and is authorized under the Respiratory Therapy Act (RTA). The practice of administering oxygen therapy clearly falls within the legislated scope of practice of Respiratory Therapy, which is:


The Respiratory Therapy Act states that the Scope of Practice of a Respiratory Therapist is:

The practice of respiratory therapy is the providing of oxygen therapy, cardio-respiratory equipment monitoring and the assessment and treatment of cardio-respiratory and associated disorders to maintain or restore ventilation.

Oxygen therapy is an expected competency of all Respiratory Therapists regardless of the practice setting. Respiratory Therapists work in a variety of practice settings including but not limited to:


Acute Care (Hospitals)


Complex Continuing Care


Long-Term Care


Independent Facilities (e.g., pulmonary function testing (PFT) labs, sleep labs, ophthalmology clinics)


Home Care


Hyperbaric Oxygen Therapy


Anesthesia (e.g., Anesthesia Assistants, dental clinics)


Independent Practice (e.g., consultants)






One of the many aims of this guideline is to provide resources and tools for Respiratory Therapists who are independently administering oxygen, to mitigate the risks that may be associated with independently administering oxygen therapy in their clinical practice.

Here are some guiding principles to consider:

Be accountable and act in the best interest of your patients/clients at all times;
Ensure safe and ethical care;
Act within the scope of practice of the profession, the role and scope of where you work and your individual scope of practice;
Maintain the standards of your profession;
Ensure that you are competent or become competent to do what you are going to do before you do it;
Communicate with patients/clients and healthcare providers within the circle of care;
Educate your patients/clients and healthcare providers within the circle of care; and
Document… Document… Document!

Did You Know?

Circle of Care: Sharing Personal Health Information for Health Care Purposes – IPC

The term “circle of care” is not a defined term in the Personal Health Information Protection Act, 2004 (PHIPA). It is a term commonly used to describe the ability of certain health information custodians to assume an individual’s implied consent to collect, use or disclose personal health information for the purpose of providing health care, in circumstances defined in PHIPA.

To find out more visit the Information and Privacy Commissioner of Ontario at

Conflict of Interest

A conflict of interest is created when you put yourself in a position where a reasonable person could conclude that you are undertaking an activity or have a relationship that affects or influences your professional judgment.

You must ensure that your professional judgment is not influenced by and does not appear to be influenced by financial or other consideration. You should not be seen, or perceived, to give preferential treatment to any person or organization.

Respiratory Therapists must protect the trust relationship between themselves and their patients/clients. Do not place yourself in a position where a reasonable patient/client, or other person, might conclude that your professional expertise or judgment may be influenced by your personal interests, or that your personal interests may conflict with your duty to act in the best interests of your patient/client. It is not necessary for your judgment to actually be compromised.

For example, a conflict of interest (actual or perceived) may arise if you are the proprietor of a home oxygen company (vendor) and you are the Respiratory Therapist who is assessing and administering oxygen therapy.  It could be perceived that you are administering oxygen therapy for personal or financial interests.    Please refer to the CRTO Conflict of Interest regulation and/or the Professional Practice Guideline (PPG) on Conflict of Interest to ensure that, as the RRT independently administering oxygen therapy, you are not in a conflict of interest.

The Ministry of Health and Long Term Care’s (MOHLTC) Assistive Devices Program (ADP) has a Conflict of Interest policy that describes possible scenarios where a conflict of interest may exist between registered oxygen vendors and authorizers.  Home oxygen service providers (vendors and authorizers) must be registered with the MOHLTC’s ADP Home Oxygen Program (HOP) in order to provide home oxygen and respiratory therapy devices to patients/clients in the community.  To find out more, visit the MOHLTC’s ADP at:

Home Oxygen Program (HOP) Documents and Respiratory Therapists

The Assistive Devices Program (ADP) has expanded the role of hospital-based and some community-based RRTs by authorizing them to complete the Application for Funding Home Oxygen (application) in place of the prescriber.  This expanded role recognizes the specialized training and expertise Respiratory Therapists have regarding oxygen administration, as well as the vital part they play in the implementation of home oxygen.

Please follow this link to find important information about this and other recent changes to the ADP-funded home oxygen therapy.


(ATP) Ambient Temperature and Pressure = (STP) standard temperature and pressure = 0C and 1 atmosphere

BTPS = Body Temperature and ambient Pressure Saturated = 37 °C, 1 atmosphere, and 44 mg H2O/L

Conserving Devices - How long liquid and cylinder systems last before refilling depends on the amount of oxygen a person uses. Conserving devices extend the length of time. Oxygen systems deliver oxygen continuously during inspiration and exhalation. Conserving devices can be programmed to deliver oxygen during inspiration only, therefore reducing the amount wasted during exhalation.

Cryogenic Vessel - A static or mobile vacuum insulated container designed to contain liquefied gas at extremely low temperatures. Mobile vessels could also be known as "Dewars". Retrieved from:

Drug Identification Number (DIN) - a computer-generated eight-digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada and is located on the label of prescription and over-the-counter drug products that have been evaluated and authorized for sale in Canada. A DIN uniquely identifies the following product characteristics: manufacturer; product name; active ingredient(s); strength(s) of active ingredient(s); pharmaceutical form; route of administration. Retrieved from:

Fractional Distillation - the process of separating the portions of a mixture by heating it and condensing the components according to their different boiling points. Retreived from:

Medical gas - (either a single gas or a mixture of gases) is a gas that requires no further processing in order to be administered, but is not in its final package (e.g., liquefied oxygen) and is known as a bulk gas. Retrieved from:

Manifold (rampe) - Equipment or apparatus designed to enable one or more medical gas containers to be filled at a time.


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