ABSTRACT
P223 Table 1ConclusionsIn line with the literature, viral insult can lead to laryngeal hypersensitivity and hyperresponsiveness, which can manifest as a clinical spectrum, including ILO. New presentation with ILO was common in patients assessed for upper airway symptoms post-Covid-19. Correlation between referral reason and assessment outcome was poor, therefore assessment via laryngoscopy is essential to confirm diagnosis before intervention. Patients from minority ethnic groups were not referred to the service, despite being at higher risk of medical complications following Covid-19.
ABSTRACT
IntroductionOur tertiary Airways service offers assessment and treatment for Inducible Laryngeal Obstruction (ILO), (breathing difficulties due to inappropriate adduction of the larynx on inspiration). Speech and Language therapy (SLT) is identified as the ‘cornerstone’ of treatment for ILO.During the Covid-19 pandemic, we produced an online information and therapy resource to support as an adjunct to virtual therapy by SLTs. This included educational information about ILO, videos to support understanding and instructions on how to complete the SLT airway control techniques, as well as symptom monitoring measures.This paper summarises patient feedback on the resource.MethodsAn online survey was sent to 312 patients who had received the resource to support their virtual consultations.Survey questions gathered both quantitative and qualitative data based on Kirkpatrick’s (1993) model of training evaluation, focusing on: Reaction, Learning, Behaviour and Results.Results69 patients (49 females, 19 males, median age= 64, age range=26–78) completed the survey (22% response rate).The resource was rated highly by patients for quality, interest and engagement (Reaction), and for learning from it. Diagrams and demonstration videos helped them understand ILO (Learning) and practice therapy techniques outside of therapy sessions (Behaviour) and were rated as the most helpful aspects of the resource. Following use of the resource 76% reported that their ILO symptoms were either ‘better’ or ‘a lot better’ (Results). Having the resource always accessible online was described as very useful, due to offering a reminder of techniques and to help explain ILO to others.ConclusionDigital resources are a useful adjunct to remote ILO therapy, and continue to be used in our service to support face to face, as well as virtual SLT sessions for the treatment of ILO.
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Background University Hospitals of Morecambe Bay NHS Trust, witnessed an early peak of COVID-19 with related hospital admissions in early 2020, this created a need for a coordinated approach to post COVID-19 rehabilitation needs across the area. Objectives A three-armed COVID-19 rehabilitation pathway was devised in March 2020 with Arm 1 aiming to assess and address the immediate rehabilitation needs of those leaving hospital following an admission for respiratory complications of COVID-19. Methods Existing Pulmonary Rehabilitation teams were repurposed by integrated care network (MBRN) to be a new 'Virtual' rehabilitation service. A register of patients discharged from hospital sites was remotely screened for pathway suitability. Then, using a multi-professional template a holistic assessment needs was conducted using telephone and/or home visit consultations. Clinical assessment tools were built into the assessment process. Weekly 'acute-community' virtual in-service training sessions and multi-disciplinary case discussions supported the clinicians. Results To date 207 patients have entered the service for virtual triage, 138 patients were deemed suitable for further assessment and interventions. 427 direct clinician consultations were delivered to these 138 patients [122 initial telephone assessments;53 initial home visit assessments;168 follow-up telephone consultations;84 follow-up home visits]. Two of the 138 patients assessed died, both were expected deaths. No clinical incidents occurred and no staff contracted COVID-19 during this period. Feedback from the services' staff survey was very positive highlighting the supportive value of virtual training and MDT and the enjoyment of being part of creating and delivering this new service to patients recovering from COVID-19. Conclusions Utilising the skills of pulmonary rehabilitation staff to deliver a holistic rehabilitation and treatment service to those discharged from hospital after suffering respiratory complications of COVID-19 was feasible, safe and well tolerated by staff and patients. This service is now being used to address the needs of post-COVID-19 patients presenting with respiratory needs in the community. We aim also to assess clinical outcome.
ABSTRACT
P35 Figure 1ConclusionsUtilising the skills of pulmonary rehabilitation staff to deliver a holistic rehabilitation and treatment service to those discharged from hospital after suffering respiratory complications of COVID-19 was feasible, safe and well tolerated by staff and patients. This service is now being used to address the needs of post-COVID-19 patients presenting with respiratory needs in the community. We aim also to assess clinical outcome.