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Thorax 53:762-767 doi:10.1136/thx.53.9.762
  • Original article

Core guidelines for the discharge home of the child on long term assisted ventilation in the United Kingdom

  1. Elspeth Jardine,
  2. Colin Wallis
  1. The Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK
  1. Dr C Wallis, Consultant in Paediatric Respiratory Disease, Respiratory Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1N 3JH, UK.
  • Received 8 January 1998
  • Revision requested 31 March 1998
  • Revised 27 April 1998
  • Accepted 8 May 1998

Abstract

Paediatric home ventilation is a feasible option and can be successful in a wide range of conditions and ages. Advances in ventilator technology and an ethos of optimism for home care has increased the possibilities for discharging chronically ventilated children from intensive care units and acute medical beds. With careful planning the process can succeed, but difficulties often thwart the responsible team, especially when attempting discharge for the first time. These core guidelines aim to assist a smooth, swift and successful transfer. They were developed by a working party of interested professionals spanning a wide range of health care disciplines and represent a synthesis of views accumulated from the experiences of individual teams throughout the UK. Three case scenarios provide further illustrative detail and guidance.

  • Long term mechanical ventilation of children at home is feasible.

  • The numbers of children ventilated at home are increasing.

  • Early and careful planning leads to a smooth transition to home care.

  • Home ventilation has demonstrable psychological, social and economic advantages.

Footnotes

  • For the UK Working Party on Paediatric Long Term Ventilation: I Barker (Sheffield Children’s Hospital), B Boosfeld (Great Ormond Street Hospital for Children NHS Trust), R Bullock (Royal Victoria Infirmary NHS Trust, Newcastle), C Doyle (Royal Liverpool Children’s Hospital), S Kerr, R Lane (Great Ormond Street Hospital for Children NHS Trust), K Lucking (North Staffordshire Hospital), J Noyes (University of Salford), M O’Toole (Great Ormond Street Hospital for Children NHS Trust), J Y Paton (Royal Hospital for Sick Children, Glasgow), H Porter (Royal Hospital for Sick Children, Edinburgh), M Samuels (North Staffordshire Hospital), J Shneerson (Papworth Hospital), A Simonds (Royal Brompton Hospital), A Walker (St George’s Hospital), T Ward (Chailey Heritage), J W H Watt (Spinal Injuries Unit, Southport), R Yates (Royal Manchester Children’s Hospital).