|Title:||Clinical Specialist Respiratory Physiotherapy Management of the High Risk Non Invasive Ventilation (NIV) and High flow Oxygen Therapy (HFOT) Patient in Cork University Hospital.|
|Author(s):||AM, Fitzgerald, S, Healy, M, O'Grady, A, Hallahan.|
|Institution:||Cork University Hospital|
|Poster:||Click to view poster|
|Abstract:||Objective – To evaluate the impact the role of the Clinical Respiratory Physiotherapist has in the cohort of the High Risk Respiratory Non Invasive Ventilation (NIV)/High Flow Oxygen Therapy (HFOT) Patients in Cork University Hospital (CUH).|
Method – Over a two month period,( Jan 2021 – Feb 2021) all high risk NIV/HFOT respiratory patients, that were identified on an NIV Tracking system for NIV machines, were reviewed by the Respiratory Clinical Specialist Physiotherapist. High Risk included those on FiO2 >60%, flowrate > 50l/min, PEEP >10 and IPAP >12. The Physiotherapeutic Treatments performed and further care provided to escalate the care of the patient was documented.
Results – Out of a population of 60 patients, 75% (45/60) were referred due to low oxygen saturations and 68% (41/60) was due to a change in the Early Warning Score (EWS). The most frequently provided CSP Physiotherapeutic Treatment included arterial blood gas recommendation (68%); arterial blood gas sampling (56%); Initial NIV/HFOT set up (63%); FiO2 changes made (66%); ceiling of care discussion with team (51%) and NIV/HFOT settings changes (68%). To further ensure escalation of care for this cohort of patients, the CSP Resp Physio requested Anaesthetic Review in 50% of these cases and only 17% of these 60 patients were admitted to Intensive Care.
Hospital Outcome for these High Risk Patients show that 58% were discharged home and 40% had an inpatient mortality outcome. Of those admitted to Intensive Care (n=10), 60% were discharged home and 40% died.
Conclusion – Clinical Specialist Respiratory Physiotherapists are valuable team members in preventing further deterioration in a High Risk Non Invasive Ventilation / High Flow Oxygen Therapy Respiratory patient. They aid with escalating care of the high risk NIV/ HFOT Respiratory patient, preventing ICU admissions in Cork University Hospital.