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Found 96 results
  1. Content Article
    The coroner raised the following matters of concern: Jeesal Cawston Park (JCP) Jeesal Akman Care Corporation was the care provider for JCP and closed in 2021. However, Jeesal Holdings Ltd, Jeesal Residential Care Services Ltd (JRCSL) and possibly other linked companies with the same directors, continue to provide residential care to persons with mental health illness, learning disabilities, complex needs and physical disability. The concerns raised at the inquest could apply to residential care offered by these companies and unless such concerns are addressed there is a risk that future deaths may occur. It is not known if the directors of these companies are directors of other companies providing care for persons with learning and other disabilities. CCTV was shown at the inquest which revealed Ben King had been assaulted in the hours prior to his death and also that 1 to 1 observation was not carried out in accordance with the Observations Policy. CCTV is a reliable means of ensuring that staff comply with Policies and residents are treated with dignity. CCTV is not available in many if not all of the residential homes owned by JHL and JRCSL. Basic dietary advice and guidance provided was not followed by staff. The use of the Dietician in training of staff was reduced in 2017 from one day’s training to an hour’s power point presentation. Important records were not completed by staff, eg Food intake, Exercise, Weight and vital observations. Evidence was heard that exercise was not regularly offered to Ben King and when the Sports Instructor was absent for lengthy periods of time, there was no replacement Multi-Disciplinary Team (MDT) Meetings were not held every 4 to 6 weeks as required. At MDT meetings which did take place, out of date weight measurements were recorded and relied upon for Ben. His increasing weight gain was not discussed at these meetings and weight loss was not set as a desirable or essential goal. JCP used the Pandora software system, (company Directors for Pandora are the same as for JHL and JRCSL) which is still used at the residential homes owned by JHL and JRCSL. Concerns were raised at the inquest in respect of this software system in that not all policies and documents were available to staff on the IPads provided, some of the documents were unwieldy and difficult to read (for example, Personal Healthcare Plan), the Dietician recommended use of paper records in respect of Food and Fluid intake as these would be more accessible to staff and encourage the documents to be completed or in the alternative providing for the records on Ipads to be more easy to access and complete. The internal investigation carried out following Mr Ben King’s death did not capture the concerns raised at inquest. Evidence was heard that no substantive changes have been made at the residential homes owned by JHL and JRCSL following the death of Ben King and the closure of JCP to deal with these concerns. Norfolk and Norwich University Hospital (NNUH) Guidance was sought by Emergency Department (ED) when Ben King attended on 10 July 2020 from a Respiratory Consultant, who was not made aware that Ben King had attended some 6 hours earlier with the same symptoms. The Respiratory on call consultant was not contacted when Mr King returned to NNUH two days later on the 12 July 2020 with the same symptoms. At the time of Ben King’s attendance at NNUH, Ben King was under the Respiratory Team and had been seen a few days earlier, on 3 July 2020. The Respiratory Team was not made aware of Ben King’s attendances at ED on 9, 10 or 12 July 2020 with respiratory problems. Advice given on discharge appears to be unclear and contradictory. The expert Respiratory Consultant referred to the advice as being “inadequate, unclear and inaccurate” On the Discharge Form provided on 9 July 2020 it is noted “Plan – home as Ben is back to normal, self, red flags and safety netting covered, to return in the event of any difficulty.” On discharge from ED on 10 July 2020 (second occasion) the hospital record states that Ben King is to return home, encouraged to lose weight, fluids are to be encouraged and “with no need to monitor his sats unless clinically unwell with sats in 60s%”. Not all of this information was included in the Discharge Form on 10 July 2020: The Discharge Form provided under “Other” - “seen by respiratory team, they are happy to send him home, they have clerked their advice on the paper. CPAP and O2” On 12 July 2020 the Discharge Plan provided “Home”. The advice from the Respiratory Consultant seen on 3 July 2020 was for CPAP to stop. Evidence was heard from the Care staff at JCP that they were unclear as to what the plan was with regard to Ben and specifically as to when Ben was to be returned to Hospital. One of the Doctors at JCP contacted the ED, NNUH to try to ascertain what the advice was and was unable to get any substantive response. Email contact was made with the Respiratory Team but no response was received until after Ben King’s death on 28 July 2020. The section headed “Drug History” was not completed on the Discharge Form on Ben King’s attendances on 9 or 12 July 2020. On 10 July, it states “nil significant”. This is despite Ben King being prescribed Promethazine, a sedative medication, affecting the respiratory system. Evidence was heard that not all prescribed medications could be expected to be included in “the small space” provided. That this is a medication where consideration would have been given to a risk/benefit analysis but there was no evidence of any such analysis. Regulation 28 evidence was that not all medication can be listed; only “pertinent” medication. Promethazine would appear to be such a medication. Arterial and venous blood gas samples were taken from Ben King on his attendances on 9 and 10 July 2020, which the Respiratory Consultant said in evidence were incomparable (although this was not the evidence of the Expert Respiratory Consultant). No blood gas samples were taken on the 12 July 2020. A copy of this report was sent to: The Chief Coroner Clinical Commissioning Group Norfolk Safeguarding Adults Review Group Care Quality Commission Department of Health Healthcare Safety Investigation Branch (HSIB) Healthwatch - Norfolk
  2. News Article
    The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long-term conditions. Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy. England’s health and social care secretary, Steve Barclay, told the House of Commons on 24 January that the strategy would build on measures in the NHS long term plan. Read full story (paywalled) Source: BMJ, 25 January 2023
  3. News Article
    Intensive care doctors in Germany have warned that hospital paediatric units in the country are stretched to breaking point in part due to rising cases of respiratory infections among infants. The intensive care association DIVI said the seasonal rise in respiratory syncytial virus (RSV) cases and a shortage of nurses was causing a “catastrophic situation” in hospitals. RSV is a common, highly contagious virus that infects nearly all babies and toddlers by the age of two, some of whom can fall seriously ill. Experts say the easing of coronavirus pandemic restrictions means RSV is affecting a larger number of babies and children, whose immune systems aren’t primed to fend it off. Cases of RSV and other respiratory illnesses have also increased in the UK and in the US, which is also suffering from a shortages of antivirals and antibiotics. In Germany, hospital doctors are having to make difficult decisions about which children to assign to limited intensive care beds. In some cases, children with RSV or other serious conditions are getting transferred to hospitals elsewhere in Germany with spare capacity. “If the forecasts are right, then things will get significantly more acute in the coming days and week,” Sebastian Brenner, head of the paediatric intensive care unit at University Hospital Dresden, told German news channel n-tv. “We see this in France, for example, and in Switzerland. If that happens, then there will be bottlenecks when it comes to treatment.” Others warned that, in certain cases, doctors already were unable to provide the urgent care some children need. “The situation is so precarious that we genuinely have to say children are dying because we can’t treat them any more,” Dr. Michael Sasse, head of paediatric intensive care at Hanover’s MHH University hospital, said. Read full story Source: The Guardian, 1 December 2022
  4. News Article
    A health visitor wrote to housing officials expressing concern about conditions in a rented flat months before a two-year-old died after his exposure to mould. An inquest in Rochdale is investigating the death of toddler Awaab Ishak who lived with his mother and father in a one-bedroom housing estate flat managed by Rochdale Boroughwide Housing (RBH). Awaab’s father, Faisal Abdullah, first reported the damp and mould in autumn 2017, a year before the birth of his son. He made numerous complaints – phoning and emailing – and requested re-housing. In December 2020 Awaab developed flu-like symptoms and had difficulty breathing. He was given hospital treatment and then discharged. Two days later his condition at home worsened and he was seen at Rochdale urgent care centre where he was found to be in respiratory failure. He was transferred to Royal Oldham hospital where, upon arrival, he was in cardiac arrest and died. It was just a week after his second birthday. A pathologist told the inquest that the child’s throat was swollen to an extent it would compromise breathing. Exposure to fungi was the most plausible explanation for the inflammation. Lawyers for the family say the inquest will consider a number of matters including concerns about mould and damp and how they were dealt with. It will also look at the sharing of information between agencies and how the family’s cultural and language requirements were taken into account. Officials from RBH have yet to give evidence at the inquest but a statement was provided to the coroner on Tuesday in which RBH admits it “should have taken responsibility for the mould issues and undertaken a more proactive response”. Read full story Source: The Guardian, 8 November 2022
  5. News Article
    A teenager died after a breathing tube was possibly squashed by a wheel of her hospital trolley during emergency surgery, an inquest has heard. Jasmine Hill, 19, had a cardiac arrest shortly after undergoing a procedure on her neck at Gloucestershire royal hospital in Gloucester. The inquest heard that a report commissioned by lawyers acting for Hill’s family referred to the tube being “squashed by the wheel of a trolley”. Hill, from Cirencester, had been readmitted to the hospital after her neck became swollen five days after a thyroidectomy – the removal of all or part of the thyroid gland – in September 2020. Doctors thought the site of the surgery in Hill’s neck, which was red and swollen, may have become infected and it was decided the wound should be cleaned under general anaesthetic. The procedure took less than an hour and the teenager went into cardiac arrest shortly after she was moved by staff from the operating table to a bed. Gloucestershire coroner’s court heard an endotracheal tube, which supports breathing, was positioned behind Hill’s head and away from her neck, fixed to a holder and connected to the ventilator. The assistant Gloucestershire coroner Roland Wooderson asked Dr Hiro Ishii, who carried out the procedure, whether he was aware that the anaesthetist had checked the position of the endotracheal tube. Ishii replied: “I didn’t make a formal inquiry at that stage.” Read full story Source: The Guardian, 7 November 2022
  6. News Article
    Lung cancer screening should be offered to over-55s who have smoked, government advisers have said. New guidance from the UK National Screening Committee has called for a mass introduction of checks for all present and former smokers between the ages of 55 and 74. While the NHS offers routine screening for other types of cancer, including breast, bowel and cervical, there is no lung cancer screening programme. Lung cancer is the UK’s deadliest form and every year 48,000 people are diagnosed, with 35,000 deaths. The death rate is so high because it is often spotted when symptoms develop and it is too late for treatment. Only 5% of those diagnosed with lung cancer at the latest stage survive for five years, but when picked up early more than half survive. Officials have recommended targeted screening to cut death rates. It involves a CT scan which takes a detailed picture of the lungs to look for abnormalities. The National Screening Committee said that targeting all of those who have smoked would reduce deaths because 70% of lung cancer cases are caused by smoking. Read full story (paywalled) Source: The Times, 30 September 2022
  7. News Article
    More than a million people in the UK have experienced life-threatening asthma attacks after cutting back on medicine, heating or food amid the soaring cost of living crisis, a survey suggests. One in five (20%) people living with asthma in the UK – of which there are 5.4 million – have had an attack as a result of changes they have been forced to make due to rising energy, food and household bills, according to the research by Asthma + Lung UK. Fuel poverty campaigners described the figures as “distressing”. Almost half of the 3,600 people with lung conditions such as asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis surveyed by the charity said their health had worsened since the crisis began. Asthma + Lung UK warned there could be a “tidal wave” of hospital admissions in the next few months as cold weather, an abundance of viruses and people cutting back on medicines, heating, food and electricity put them at increased risk. Sarah Woolnough, the charity’s chief executive, said: “Untenable cost of living hikes are forcing people with lung conditions to make impossible choices about their health. “Warm homes, regular medicine and a healthy diet are all important pillars to good lung condition management – but they all come at a cost. We are hearing from people already reporting a sharp decline in their lung health, including many having life-threatening asthma attacks. Read full story Source: The Guardian, 28 September 2022
  8. Content Article
    E-learning course module - Free 30-minute digital module is available to all GP’s and medical professionals to help spot the signs and symptoms of progressive lung fibrosis. The course covers everything the generalist in primary care needs to know about idiopathic pulmonary fibrosis. This will include pathophysiology, presentation, natural history, treatment options, exacerbations, oxygen therapy, lung transplant, advanced care planning and end of life care. Pulmonary fibrosis leaflet - You can print this to give to your patients. The flyer includes details about life with pulmonary fibrosis and a medical information form for your patient to complete. Support information leaflet Hospital poster
  9. Event
    Join respiratory specialists, Dr Daryl Freeman and Dr Vincent Mak, for this interactive webinar. This 1-hour, interactive webinar will cover: Community ‘hublets’. The outpatient transformation workstream. Community Diagnostic Centres (CDCs) and Primary Care Networks (PCNs). Quality assurance and interpretation of spirometry. Register
  10. News Article
    Cold homes will damage children’s lungs and brain development and lead to deaths as part of a “significant humanitarian crisis” this winter, health experts have warned. Unless the next prime minister curbs soaring fuel bills, children face a wave of respiratory illness with long-term consequences, according to a review by Sir Michael Marmot, the director of University College London’s Institute of Health Equity, and Prof Ian Sinha, a respiratory consultant at Liverpool’s Alder Hey children’s hospital. Sinha said he had “no doubt” that cold homes would cost children’s lives this winter, although they could not predict how many, with damage done to young lungs leading to chronic obstructive pulmonary disease (COPD), emphysema and bronchitis for others in adulthood. Huge numbers of cash-strapped households are preparing to turn heating systems down or off when the energy price cap increases to £3,549 from 1 October, and the president of the British Paediatric Respiratory Society, also told the Guardian that child deaths were likely. “There will be excess deaths among some children where families are forced into not being able to heat their homes,” said Dr Simon Langton-Hewer. “It will be dangerous, I’m afraid.” Read full story Source: The Guardian, 1 September 2022
  11. News Article
    A grieving family has welcomed new guidance to try to prevent a common surgical procedure from going wrong and causing deaths. Oesophageal intubation occurs when a breathing tube is placed into the oesophagus, the tube leading to the stomach, instead of the trachea, the tube leading to the windpipe. It can lead to brain damage or death if not spotted promptly. Glenda Logsdail died at Milton Keynes University Hospital in 2020 after a breathing tube was accidentally inserted into her oesophagus. The 60-year-old radiographer was being prepared for an appendicitis operation when the error occurred. Her family welcomed the guidance, saying in a statement: “We miss her terribly but we know that she’d be happy that something good will come from her tragic death and that nobody else will go through what we’ve had to go through as a family." Oesophageal intubation can occur for a number of reasons including technical difficulties, clinician inexperience, movement of the tube or “distorted anatomy”. The mistake is relatively common but usually detected quickly with no resulting harm. The new guidance, published in the journal Anaesthesia, recommends that exhaled carbon dioxide monitoring and pulse oximetry – which measures oxygen levels in the blood – should be available and used for all procedures that require a breathing tube. Experts from the UK and Australia also recommended the use of a video-laryngoscope – an intubation device fitted with a video camera to improve the view – when a breathing tube is being inserted. Read full story Source: The Independent,18 August 2022
  12. Content Article
    Key recommendations Exhaled carbon dioxide monitoring and pulse oximetry should be available and used for all episodes of airway management. Routine use of a videolaryngoscope is recommended whenever feasible. At each attempt at laryngoscopy, the airway operator is encouraged to verbalise the view obtained. The airway operator and assistant should each verbalise whether ‘sustained exhaled carbon dioxide’ and adequate oxygen saturation are present. Inability to detect sustained exhaled carbon dioxide requires oesophageal intubation to be actively excluded. The default response to the failure to satisfy the criteria for sustained exhaled carbon dioxide should be to remove the tube and attempt ventilation using a facemask or supraglottic airway. If immediate tube removal is not undertaken, actively exclude oesophageal intubation: repeat laryngoscopy, flexible bronchoscopy, ultrasound and use of an oesophageal detector device are valid techniques. Clinical examination should not be used to exclude oesophageal intubation. Tube removal should be undertaken if any of the following are true: Oesophageal placement cannot be excluded Sustained exhaled carbon dioxide cannot be restored Oxygen saturation deteriorates at any point before restoring sustained exhaled carbon dioxide. Actions should be taken to standardise and improve the distinctiveness of variables on monitor displays. Interprofessional education programmes addressing the technical and team aspects of task performance should be undertaken to implement these guidelines.
  13. Event
    Dr Donna Prosser, Chief Clinical Officer at the Patient Safety Movement Foundation, is joined by a group of experts, including pharmacists, anesthesiologists, respiratory therapists, family members, and nursing leaders, to explore the patient safety priorities of sedation, opioid therapy and respiratory depression. The group will discuss frequently encountered safety issues, explore organisational processes to reduce sedation safety events, and assess the role patients and family members can play in reducing harm. Register
  14. Event
    The Patient Safety Movement Foundation is proud to partner with MedStar Health to offer free Continuing Education (CE) credit for this patient safety webinar. With Dr. Arthur Kanowitz, Dr. Sarah Kandil, Dr. Edwin Loftin, Dr. Anne Lyren, Dr. Kevin McQueen and Dr. Lauren Berkow. Free CE offered for physicians and nurses. This activity has been approved for AMA PRA Category 1 Credits™ and ANCC contact hours. Registration