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Showing results for tags 'Medicine - Respiratory'.
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Non-invasive ventilation deaths fell for first time in 2019, audit finds
Patient Safety Learning posted a news article in News
Inpatient mortality among people receiving non-invasive ventilation (NIV) has decreased for the first time since 2010, falling from 34% in 2013 to 26% in 2019, figures released by the British Thoracic Society show. The annual National Adult Non-Invasive Ventilation audit, which began in 2010, reported “substantial improvements in processes of care and patient outcomes” in 2019 when compared with previous years. “Some improvement in overall mortality may be attributed to improved patient selection,” it said. “Mortality outcomes were lower for each diagnostic category, and most notably for patients with COPD [chronic obstructive pulmonary disease] and obesity-related respiratory failure.” Read full story (paywalled) Source: BMJ, 10 July 2020 -
Content ArticleSome key findings from the audit: Inpatient mortality was 26%. It has reduced from 34% in 2013 and represents the first time that mortality has improved since the first BTS audit in 2010. Compared to the last audit, an increased proportion of patients treated with acute non-invasive ventilation (NIV) had COPD, the indication with the strongest evidence. We saw a decreased proportion of patients who were treated with NIV despite no clearly documented indication. This suggests improved patient selection in line with the evidence base for NIV. 50% of patients treated with NIV started NIV treatment within 60 minutes of the blood gas that defined the need for NIV. Clinician responses indicate a reduced perception of treatment delay in comparison to prior audits. Acute NIV was successful in resolving respiratory acidaemia for 76% of patients treated, in comparison to 69% in the last audit (2013). Only 74% of organisations reported that they have sufficient capacity to deliver the routine acute NIV service. Only 52% of organisations had a nursing lead and 34% had a physiotherapy lead for their acute NIV service.
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News ArticleThe lungs and hearts of patients damaged by the coronavirus improve over time, a study has shown. Researchers in Austria recruited coronavirus patients who had been admitted to hospital. The patients were scheduled to return for evaluation 6, 12 and 24 weeks after being discharged, in what is said to be the first prospective follow-up of people infected with COVID-19, which will be presented at today's European Respiratory Society International Congress. Clinical examinations, laboratory tests, analysis of the amounts of oxygen and carbon dioxide in arterial blood, and lung function tests were carried out during these visits. At the time of their first visit, more than half of the patients had at least one persistent symptom, predominantly breathlessness and coughing, and CT scans still showed lung damage in 88% of patients. But by the time of their next visit, 12 weeks after discharge, the symptoms had improved, and lung damage was reduced to 56%. Dr Sabina Sahanic, a clinical PhD student at the University Clinic in Innsbruck and part of the team that carried out the study, said: "The bad news is that people show lung impairment from COVID-19 weeks after discharge; the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves." A separate presentation to the congress said that the sooner COVID-19 patients started a pulmonary rehabilitation programme after coming off ventilators, the better and faster their recovery. Yara Al Chikhanie, a PhD student at the Dieulefit Sante clinic for pulmonary rehabilitation and the Hp2 Lab at the Grenoble Alps University in France, used a walking test to evaluate the weekly progress of 19 patients who had spent an average of three weeks in intensive care and two weeks in a pulmonary ward before being transferred to a clinic for pulmonary rehabilitation. She said: "The most important finding was that patients who were admitted to pulmonary rehabilitation shortly after leaving intensive care progressed faster than those who spent a longer period in the pulmonary ward where they remained inactive. The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients' walking and breathing capacities and muscle gain." Read full story Source: The Independent, 7 September 2020
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Event
Airway safety webinar
Patient Safety Learning posted a calendar event in Community Calendar
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 -
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NHS: Your COVID Recovery
PatientSafetyLearning Team posted an article in Resources for patients
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Winter warning as 35,000 respiratory diagnoses delayed due to pandemic
Patient Safety Learning posted a news article in News
Patients with respiratory disease have been overlooked during the COVID-19 pandemic, with the NHS storing up problems for the winter months, a group of experts including the Royal College of General Practitioners (RCGP) has warned. Analysis by the 34-member Taskforce for Lung Health showed that referrals for lung conditions fell by 70% in April, with two-in-five (39%) of CCGs seeing no appointment bookings for respiratory conditions for the whole of May. On average, the group calculated a weekly average of 3,399 lung patients missing out on urgent and routine referrals during the COVID-19 lockdown, amounting to a total of at least 34,780 people, based on NHS England data. This was blamed in part on a general reduction in routine procedures during the pandemic, which will have affected all disease areas, but also the limitations on clinicians including GPs to carry out spirometry due to the risk of COVID-19 infection spread. But the taskforce - which includes the RCGP and the Primary Care Respiratory Society, as well as the Royal College of Physicians and Asthma UK - is now calling on NHS England to urgently restore services to pre-pandemic levels to tackle the backlog of lung patients requiring support. It said that failure to do so risked causing the premature death of patients who require urgent diagnosis as well as overwhelming the NHS during the winter season, when respiratory symptoms worsen. Read full story Source: Pulse, 9 July 2020 -
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Coronavirus: Warning thousands could be left with lung damage
Patient Safety Learning posted a news article in News
Tens of thousands of people will need to be recalled to hospital after a serious OVID-19 infection to check if they have been left with permanent lung damage, doctors have told the BBC. Experts are concerned a significant proportion could be left with lung scarring, known as pulmonary fibrosis. The condition is irreversible and symptoms can include severe shortness of breath, coughing and fatigue. Research into the prevalence of lung damage caused by COVID-19 is still at a very early stage. It's thought those with a mild form of the disease are unlikely to suffer permanent damage. But those in hospital, and particularly those in intensive care or with a severe infection, are more vulnerable to complications. In a study from China, published in March, 66 of 70 patients still had some level of lung damage after being discharged from hospital. Radiologists in the UK say, based on the early results of follow-up scans, they are concerned about the long term-effects of a serious infection. Prof Gisli Jenkins, of the National Institute for Health Research, is running assessment clinics for those discharged from hospital with COVID-19. He said: "My real concern is that never before in our lifetime have so many people been subject to the same lung injury at the same time." NHS England has said it is planning to open a number of specialist COVID-19 rehabilitation centres to help patients recover from long-term effects, including possible lung damage. Read full story Source: BBC News, 24 June 2020 -
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News ArticleDemand for oxygen from COVID-19 patients recovering at home is set to place the NHS under strain, the health service has warned. NHS England has issued guidance to out-of-hospital health providers on the extra demands likely to be placed on them given the number of people recovering after a hospital stay with the coronavirus. It warns that the provision from its home oxygen services and community respiratory teams across the NHS is expected to be an issue as the scale of demand increases. Andrew Whittamore, a practising GP and clinical lead for the Asthma UK and British Lung Foundation partnership, said concerns about the potential for hospitals to be overwhelmed in the early part of the pandemic had led to community oxygen teams being primed to take on more patients – but he described that ramping up as “a short-term fix”. “We don’t know how long people are going to need oxygen or other services for,” he said. “There are definitely going to be extra patients added on to our community teams’ workloads.” The Taskforce for Lung Health – of which the British Lung Foundation is a member – has raised particular concerns about access to pulmonary rehabilitation. An education- and exercise-based treatment, which is proven to be more effective for lung patients than many drug-based treatments, and face-to-face classes have been suspended during the pandemic. It may be that such treatment would also be helpful for some patients recovering from COVID-19. Jackie Eagleton, policy officer at the British Lung Foundation, said there had been issues with access to pulmonary rehabilitation for a long time, but the need to offer this form of support to people with lung conditions “has never been more pressing than it is now”. Read full story Source: The Independent, 16 June 2020
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Content ArticleThis statement highlights an anticipated increase in the need for rehabilitation across four main population groups: 1. People recovering from COVID-19, both those who remained in the community and those who have been discharged following extended critical care/hospital stays. 2. People whose health and function are now at risk due to pauses in planned care. 3. People who avoided accessing health services during the pandemic and are now at greater risk of ill-health because of delayed diagnosis and treatment. 4. People dealing with the physical and mental health effects of lockdown. The rehabilitation needs of these at-risk groups are vitally important and need to be met as AHPs collectively support people to recover, regain health and wellbeing, and reach their potential, and ultimately ensure we flourish as a nation.
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