Background
St Bartholomew’s Hospital is a tertiary teaching hospital in London, and is the largest cardiothoracic centre of its kind in Europe. It has 387 beds and a large throughput of cardiology, open heart surgery, thoracic surgery, oncology, and endocrinology. It is also an advanced centre for cardiorespiratory failure, providing both cardiac and respiratory ECMO for patients in extremis.
The hospital has formed a partnership with Armstrong Medical, as the company has been able to deliver products in formats specific to their needs.
Problem or Challenge
St Bartholomew’s hospital has a large burden of patients who potentially develop respiratory failure- this includes cardiology patients with acute pulmonary oedema, post operative patients across its multiple intensive care units, and oncology patients. It is also a centre for severe acute respiratory failure, managing these patients across North East/North Central London. They frequently use High Flow Oxygen Therapy (HFOT) but also have the need to provide Continuous Positive Airway Pressure (CPAP) as they see many patients where the issue is ‘failure to oxygenate’ with CPAP being a proven effective therapy for Hypoxia. They needed a system that was easy for nurses to use, provided both HFOT and CPAP allowing quick and easy transition between the therapies.
Solution
St Bartholomew’s has been using the AquaVENT® FD140 since 2016 as it was specifically designed to deliver HFOT and CPAP. AquaVENT® Flowkit circuits are used with the device. This makes it simple for nurses to transition between therapies without having to change devices or get a different circuit. They are used on hypoxic patients providing appropriate support while they recover sufficiently to satisfy their own oxygen requirements without support.
The hospital is now in the process of upgrading to the AquaVENT® FD140i which offers single increment precision for both oxygen percentage and flow rates, giving the clinicians complete control. It has an easy to see real time wave form graph of the patient’s breathing which allows the clinical team to respond to their precise requirements. Combining a device designed to deliver HFOT and CPAP with circuitry that transitions easily between therapies provides control without complexity. It allows nurses to start the prescribed therapy quickly, monitor its effectiveness and focus more of their time and expertise on the patient.
Benefits and Outcomes
St Bartholomew’s has several AquaVENT® FD140i devices and they ‘use every one of them’. The nurses, outreach team, and medical staff find the AquaVENT® FD140i highly effective in the delivery of HFOT and CPAP. The feedback from the nursing team has been very positive in respect to the device’s ease of use. The aim of the hospital is to have an AquaVENT® FD140i available to every patient in need across the floors several on each critical care unit, several on the coronary care unit, and several mobile devices available for rapid deployment to deteriorating patients.
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St Bartholomew’s Hospital, London
Dr Segun Olusanya
Intensive Care Consultant