Pioneers in patient care: consultants leading change
Northern Ireland
Innovation: Home ventilation system to help children breathe.
Dr Bob Taylor
Royal Belfast Hospital for Sick Children, Belfast
Job title: Consultant in paediatric intensive care
Specialty: Paediatric anaesthesia
There has been a sudden increase in the number of children who require a machine to assist their breathing. Modern technology is available to support respiration in adults but is not licensed for use in children. Dr Bob Taylor’s team has utilised this technology to provide safe and effective support for infants and children so that they can be moved out of intensive care and looked after at home.
Dr Taylor says: “This system helps reunite the child with his or her family. Although the ventilator is necessary to provide life support, it is quite possible for a family with community support to look after the child safely. It also releases hospital beds to allow other, seriously ill patients to be treated.”
Dr Taylor says: “The home ventilation system was introduced to help those children “stuck” in a paediatric intensive care bed where hospital and community staff were unable to see how these children could be moved to a general ward and then home.
“It has also helped us deal with the increasing waiting list of children with sleep related breathing problems at home because following studies we have discovered they benefit from night-time respiratory support. These children were having difficulty at school and their social life was impaired by chronic tiredness and lethargy, but we have seen a big improvement in their lives with better sleep patterns and better attention at school.”
The new service, introduced this year, is funded from generous donations made by bereaved families who have raised charity money, often in memory of their children who died in the Paediatric Intensive Care Unit at the hospital. Business plans have been submitted to the hospital to maintain and expand the service.
Dr Taylor says that the project is proving to be very successful. “Because we have been able to move children on to home ventilation, some of whom had been occupying beds for over one year, we anticipate being able to make available a full complement of Paediatric Intensive Care Unitbeds to deal with this year’s winter pressures.
“Also, those children with sleep-related breathing problems on night-time ventilation have had recordings of their sleep patterns repeated with very significant improvements. One child stopped breathing 50 times before, but only once after, the ventilator was introduced. He has made very good progress at school at the start of his GCSEs. His teacher told his parents ‘there is a new boy in our class’. That’s the kind of difference that home ventilation can make.”
Dr Taylor knows the service could be improved through the employment of a full-time respiratory nurse and better community resources to care for these children at home. He says: “Children in Northern Ireland deserve to be treated with the same resources and on equal terms with the rest of the UK. There needs to be less variation in the care of children. If the NHS funded this service many children would benefit. Not just those at home but also those who become very sick with meningitis or pneumonia and who need a PICU bed urgently.”