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RespiratoryNov 24, 2021

Respiratory support units saved 'thousands of lives' in the pandemic and offer a vital 'interface'

Respiratory support units (RSUs) have proved their worth in treating patients with Covid-19 symptoms and can continue to provide a vital ‘interface’ with intensive care units once the pandemic has receded.

That is the message to be relayed to physiotherapists and other members of British Thoracic Society (BTS) who are taking part in the society’s winter meeting today (25 November). The online meeting runs from 24-26 November.

The speaker, Ben Messer is a consultant in critical care and home ventilation who helped to write the BTS’s guidance on RSUs, which was published earlier this year and called for them to be rolled-out nationwide.

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Respiratory support units are a vital interface between intensive care and respiratory wards

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Dr Messer told delegates: ‘RSUs, staffed by respiratory clinicians, have worked closely with intensive care teams during the pandemic and these units have been critical in providing care to patients with Covid-19 outside of the intensive care unit. 

‘Their scope is, however, wider than Covid-19 and, if properly resourced, they will be the interface between intensive care and respiratory wards, providing safe, high quality and complex care to unwell patients with acute respiratory illnesses. 

‘RSUs are also a reminder of the close working relationship between respiratory medicine and intensive care medicine both during the pandemic and beyond.’

If properly resourced (RSUs) will be the interface between intensive care and respiratory wards, providing safe, high quality and complex care to unwell patients with acute respiratory illnesses [Ben Messer, BTS]

The BTS argues that properly resourced RSUs mean patients who are severely unwell with acute respiratory illnesses can be monitored appropriately. Clinicians using advanced oxygen delivery systems – such as continuous positive airway pressure [CPAP]) and non-invasive ventilation – have successfully treated tens of thousands of patients during the pandemic, reducing pressure on beds in intensive care units as a result. Thousands of lives have been saved as a result, the society claims.

Getting it right

Last year, NHS Getting It Right First Time (GIRFT)reported that those hospitals with RSU-like services recorded relatively low mortality rates during the pandemic. In light of their success in dealing with complex respiratory conditions, GIRFT also called for them to be established as a standard service in the NHS. See: https://www.gettingitrightfirsttime.co.uk/wp-content/uploads/2020/12/Covid19-Clinical-Practice-Guidance-S-FINAL.pdf

As hospitals brace themselves for the seasonal increase in emergency attendances and admissions – predominantly triggered by respiratory illnesses – RSUs will strengthen the ability of hospital teams to cope with the surge in sick respiratory patients, the BTS argues.

BTS chair Jon Bennett told BTS members that RSUs ‘could become one of the most positive and lasting legacies from this awful pandemic’. Professor Bennett added: ‘The skills needed to run RSUs already exist in the NHS, however, we need to prioritise RSUs and train more expert respiratory professionals rather than simply redeploying existing staff from other essential respiratory services.’

For more on RSUs, see: https://www.physioupdate.co.uk/news/specialist-physios-needed-on-respiratory-support-units-seven-days-a-week-national-guidance-stresses/

Meet the new president, Rachael Moses 

Respiratory physiotherapist Rachael Moses became the BTS president during the winter meeting.

To read an exclusive PhysioUpdate Q&A with Rachael, see: https://www.physioupdate.co.uk/news/rachael-moses-makes-history-as-the-first-physio-to-be-president-of-the-british-thoracic-society/

'Uplift' in physiotherapist numbers needed

Earlier, on the first day of the BTS winter meeting, BTS chair Jon Bennett told delegates the key to building resilience in the workforce and preventing staffing issues was a long-term plan that focused on the whole respiratory team, including physiotherapists, rather than individual professions.

Professor Bennett said: ‘We need to train more staff to develop a highly skilled respiratory workforce incorporating all our multi-professional groups, not just consultants.

‘We continue to call for 200 more respiratory specialty training numbers to improve the current shortfall in the number of respiratory consultants, but also an uplift in all members of the team, including respiratory nurses, physiologists, pharmacists, advanced clinical practitioners, physiotherapists and other allied health professionals.'

He added: ‘We must make full use of the multi-professional skills that add such value to respiratory care.’

For more information about the BTS, visit: https://www.brit-thoracic.org.uk/

Author: Ian A McMillan
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