Careful adaptation for ventilation patients

Article from 2019/2020 Auxiliaries Annual Report

The way healthcare is delivered has changed dramatically during  the COVID-19 pandemic and in order to ensure patient and community safety, many services at the RCH have had to adapt the  way they run. This includes the Sleep Service, which diagnoses and manages sleep disorders in children with complex respiratory issues.

Thanks to funding from the RCH Auxiliaries, hundreds of vulnerable respiratory patients who require ventilation can now receive the care they need and follow the recommendation to stay home as much as possible during the pandemic.

Funding provided by the Smiley, Southern Rainbows, VivaRCH, Heart to Heart, Geelong, St Kilda Auxiliaries and the President’s Fundraising Network has allowed the purchase of three oxy-capnography machines and 33 auto-titrating positive airway pressure (APAP) units, meaning children with respiratory issues can remain at home with their family instead of being admitted to hospital.

“On the recommendations from the governing national sleep body, we have ceased the majority of our sleep studies for the time being,” said Dr Mandie Griffiths, Head of Sleep Medicine at the RCH.

“This however has left many of our technology dependent patients who are at home at increased risk due to our inability to perform regular titration studies of their ventilation requirements. The vital funding, which was provided by the Auxiliaries, means we can monitor our sleep patients, either remotely from hospital or during hospital-in-the-home visits with the help of this new equipment.”

Oxy-capnography machines monitor the concentration of oxygen and carbon dioxide as children sleep and can be reviewed by doctors during hospital-in-the-home visits. They will help prevent hospital admissions for high needs patients including those with neuromuscular or lung diseases, severe airway restrictions and other disorders needing ventilator control.

APAP units provide constant air pressure through a face mask to prevent the airway collapsing. These devices can be monitored remotely from the hospital and help patients with obstructive sleep apnoea, as well as children who would usually require continuous positive airway pressure (CPAP).

“As well as supporting patients with obstructive sleep apnoea, we have a number of vulnerable patients that would usually come into hospital requiring CPAP. However, use of CPAP in respiratory patients poses a risk to staff due to aerosolisation of COVID-19,” said Mandie.

“The purchase of additional APAP machines means we can reduce our reliance on CPAP, keeping our patients and staff safe. The new devices also mean that all new patients can commence on this technology, which we can remotely adapt according to the child’s needs, without them having to come into hospital during this high risk period,” said Mandie.