Tran Tuyen, Nonoyama Mika, Cithiravel Nisha, Syed Faiza, Janevski Joanna, Chiang Jackie, Amin Reshma
Department of Respiratory Therapy, The Hospital for Sick Children, Toronto, Canada.
Department of Respiratory Therapy & Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.
Can J Respir Ther. 2021 Jul 23;57:93-98. doi: 10.29390/cjrt-2021-023. eCollection 2021.
The COVID-19 pandemic has been an unprecedented threat to our health care system. Clinicians had to pivot and develop creative and timely "virtual" solutions to provide clinical care. Our aim was to develop a standardized approach to virtual "mask fitting" for children who are either being initiated or are already on existing long-term ventilation (LTV) at a pediatric hospital.
We present three cases involving the care of children who required mask fitting for noninvasive ventilation (NIV). LTV team consultations were delivered via videoconference or phone. With the guidance of the respiratory therapist (RT), the family caregiver (FC) took measurements on their child using a standardized clinical approach (developed by the LTV RTs). Based on the measurements, an appropriate mask was selected. Successful mask fit was based on patient/FC reports, as well as objective leak data obtained from the NIV download data.
Virtual clinics used for managing patients in our LTV program were feasible and efficient resulting in improved workflow for the RTs and convenience for patients and FCs. Patients and FCs had significantly less pressure to attend in-person clinics and expressed high satisfaction in terms of their experience and importantly, meeting respiratory care needs. Within the context of COVID-19, remote patient education and intervention can be delivered effectively, while reducing the risk of exposure from in-person visits to hospital.
A virtual/telemedicine program to manage pediatric patients requiring mask fitting for LTV was a feasible option during COVID-19.
新冠疫情对我们的医疗系统构成了前所未有的威胁。临床医生不得不迅速转变思路，开发创新且及时的“虚拟”解决方案来提供临床护理。我们的目标是为一家儿科医院中刚开始或已经在接受长期通气（LTV）的儿童开发一种标准化的虚拟“面罩适配”方法。
我们呈现三例涉及需要为无创通气（NIV）进行面罩适配的儿童护理病例。LTV团队通过视频会议或电话进行会诊。在呼吸治疗师（RT）的指导下，家庭护理人员（FC）使用标准化临床方法（由LTV的RTs制定）为其孩子进行测量。根据测量结果，选择合适的面罩。面罩适配成功基于患者/FC的报告以及从NIV下载数据中获得的客观漏气数据。
用于管理我们LTV项目中患者的虚拟诊所是可行且高效的，这改善了RTs的工作流程，为患者和FCs带来了便利。患者和FCs亲自到诊所就诊的压力显著减轻，并且对他们的体验，以及重要的是对满足呼吸护理需求方面表达了高度满意。在新冠疫情背景下，可以有效提供远程患者教育和干预，同时降低因亲自到医院就诊而暴露的风险。
在新冠疫情期间，一个用于管理需要为LTV进行面罩适配的儿科患者的虚拟/远程医疗项目是一个可行的选择。
