Respiratory Specialist Nurses Ext 5149

Penny Rideal

Wendi Hodge

Jenny Downham

They offer specialist nurse input / assessment / education and clinic assessment. They are happy to see patients both on the ward and in clinic.

They are happy for medical students to attend clinics and offer excellent education in COPD/Asthma management, inhaler technique, NIV and spirometry.

They are happy to provide ward teaching to junior doctors on a range of subjects such as NIV initiation, management if chest drains and inhaler technique.

Lung Cancer Specialist Nurses Bleep 2777 or Ext 6249

Rachel Mountfield

Laura Hall

Michelle Allen

Both work with the respiratory team and have links to oncology / palliative care. They are happy to get involved early if a patient with suspected or known lung cancer is admitted or seen in clinic. They are happy to advise regarding future management and follow up arrangements of patients undergoing outpatient investigations.

Specialist Respiratory Physiotherapist - Sam Roberts

Out patients clinics for patients referred for pulmonary rehabilitation and requiring assistance for sputum clearance techniques and strategies for hyperventilation.

TB Specialist Nurse – Celia Proudfoot

Clinics undertaken include TB screening, Mantoux/Quantiferon testing and contact screening.

Respiratory Early Supported Discharge Team

Samantha Haughton / Ceri Whitehead

Provide respiratory support and facilitate early discharge, supporting patients with COPD.

Oxygen Assessment Nurse Ext 2541

Amanda Morris / Laura Challenor

Services

Chest Drains

Chest drains are inserted by any medical doctor but the patient usually should be under the care of the respiratory team, ideally on ward 48. The use of ultrasound in the placement of chest drains is increasing and is likely to become mandatory for the drainage of pleural effusions.

Respiratory Support Unit, Ward 

Non Invasive ventilation is delivered on the RSU within ward 44 for those patients with acidotic Type II respiratory failure.

Guidelines for its administration can be found on the intranet. A consultant ward round of patients on the RSU happens at 9am weekdays. Training can be acquired via the respiratory team / specialist nurses.

The video below is an excellent resource explaining acute NIV (Courtesy of the NIHR ARC Northwest London)

Speciality Asthma Clinic. (Thurs am.)

Provides specialist treatment and management of severe disease. This is one of a number of regional asthma services with close links to tertiary services. Junior members attending this clinic will have the opportunity to attend regional asthma meetings.

Bronchoscopy

This is performed as a day case in the Endoscopy Unit every Wednesday pm and Monday pm. The list is undertaken by each consultant in rotation. All patients are pooled and usually patients will not have to wait more than a week for the procedure. The patients will need to be starved from 8am the morning of the procedure. They are usually done with sedation. Consent should be obtained whilst an inpatient or during clinic not on the day of the procedure. Patient information leaflets to support consenting are available on the intranet. Patient information leaflets regarding instructions of where to attend etc can be found in OPD3

Bronchoscopies can only be booked by the respiratory team.

Telephone the Endoscopy Unit on ext: 4417 to book.

Endobronchial ultrasound (EBUS)

A procedure similar to a bronchoscopy. It is done on the Wednesday bronchoscopy list under an anaesthetic, it has the benefits of assisting in the sampling if mediastinal lymphadenopathy. When booking an EBUS please discuss with Dr Benton first. The secretaries will need to be informed to arrange the anaesthetist.

CPAP Clinic

Marie  / Hugo  CRV Department Ext 5210

Interstitial Lung Disease Clinic

Dr Ponnuswamy runs the ILD clinic, joining him would be a good learning opportunity for junior members of the team.

Pulmonary Rehabilitation

An exercise/education programme that is offered to patients with COPD. It involves 2 x 2 hour sessions over 6 weeks. Patients are assessed and exercised with supervision, along with receiving education to assist with coping with breathlessness, benefits, mobility etc.

Patients are referred to Sam Roberts usually from clinic.

Calman Lung Clinic (Rapid Access Lung Cancer Clinic)

This is a dedicated rapid access clinic for patients with suspected lung cancer. Urgent patients are seen in dedicated fast track clinics on a Tuesday, Wednesday and Friday morning

Urgent CT appointments can be accessed via this clinic to speed up the patient journey for the investigation of lung cancer. Patients usually undergo a bronchoscopy the next day with all available results being reviewed at the weekly Lung MDT the following Tuesday. (2-3pm in the radiology seminar room). The Calman Review clinic continues after the MDT

The MDT is coordinated by Chris. Ext 3757

Oncology

Oncology specialists visit weekly from Clatterbridge Cancer Centre. The Clinical Oncologists that administer chemotherapy and radiotherapy for NSCLC lung cancer are Dr Allison Hall & Dr Mary Anthony-Pillai. The treatment of Small cell lung cancer is usually chemotherapy.

Thoracic Surgery

A visiting Cardiothoracic surgeon (Mr Whoolley) attends the MDT alternate weeks. He then runs a clinic in OPD 3, seeing both new referrals and follow ups. Enquiries regarding this clinic can be made with the team secretary (Ext 6297) or via the Lung cancer specialist nurses.

Interventional Radiology

Percutaneous biopsies can be obtained with the assistance of ultrasound and/or CT. Patients are usually discussed at the MDT with the radiologists. Patients need consenting and an up to date INR prior to the procedure. Instructions regarding post procedure care are sent back with the patient to the ward.

Pulmonary function tests - Cardio Respiratory Vascular Department (CRV)

Patients attending OPD 3 can have spirometry performed in clinic.

All other requests for spirometry or detailed lung function should be made with the Cardio respiratory department. Tests on offer are: Full lung function test including spirometry, lung volumes, diffusion; overnight oximetry, histamine challenge and reversibility tests.

Education

Numerous opportunities exist for education, both arranged and ad hoc.

Research

The Chester Respiratory Research Unit has links with the University of Chester and also actively participates in national / international research trials. There are opportunities to become involved for those wishing to gain experience in research methods and also for quality improvement projects within the respiratory department.