Inside the NHS: Helping our patients to breathe easy

In the first article of a new column from the NHS in Northumberland giving us an insight into fantastic work they do, Karen Brewin, from Northumbria Healthcare NHS Foundation Trust, talks about the work of the respiratory physiotherapy team that she leads.
Respiratory physiotherapist Karen BrewinRespiratory physiotherapist Karen Brewin
Respiratory physiotherapist Karen Brewin

The main role of a respiratory physiotherapist is to help patients to breathe better, by clearing secretions from the lungs, increasing lung volume and reducing the amount of effort needed to breathe.

This is achieved in a variety of ways, including teaching patients different breathing techniques.

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If patients are unable to do effective techniques by themselves, then we may help them to achieve the same effect with equipment, for example, to help a patient to take a bigger breath than they can manage on their own.

Northumbria Specialist Emergency Care Hospital, Cramlington.Northumbria Specialist Emergency Care Hospital, Cramlington.
Northumbria Specialist Emergency Care Hospital, Cramlington.

We see patients who are extremely sick and who may be ventilated and sedated on critical care as well as patients who are well enough to be discharged from hospital.

We also see outpatients referred to us for the likes of breathing pattern disorders, asthma, lung cancer and cardiac rehabilitation.

Over the past year, our attention has been focused on the Covid-19 pandemic.

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We have been on the frontline in critical care, the respiratory support unit and on other wards treating many patients who were Covid-positive with oxygen therapy, CPAP (continuous positive airway pressure) and proning, which is helping patients to lie on their front to improve how much oxygen the patients can get into their lungs.

Many patients with Covid-19 have spent prolonged stays on critical care and the respiratory support unit, requiring a lot of physiotherapy treatment time per patient per day, and it has been really important to have amazing teamwork in order to provide the best care for these patients.

We have worked closely with doctors, nurses, pharmacists, dietitians as well as the medical engineering, procurement and supplies teams, while being supported by domestic staff too.

As a team, we have faced very difficult challenges with patients who required end-of-life care and very happy times when we have helped patients to recover from being on ventilation to being discharged home from hospital.

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We are now part of the post-Covid-19 multi-disciplinary team clinic, seeing our patients who were critically ill following their discharge from hospital and those suffering with respiratory symptoms from long Covid. It has been an incredibly challenging year, one in which we had many new things to learn very quickly.

Our clinical practice has had to adapt so that we can treat a new illness, but we now have hope with the roll-out of the vaccination.

We look forward this year to seeing more of our outpatient caseload again and welcoming our patients with chronic obstructive pulmonary disease (COPD) back to rehabilitation.

This service is so important because it reduces hospital admissions and improves functional ability, breathlessness and quality of life for people in the community.