Alder Hey in the Park | Alder Hey Children's Hospital

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Physiotherapy - in the hospital

Chest physiotherapy helps children to breathe more easily and helps to remove excess secretions from their lungs. We treat children with a diverse range of respiratory conditions and have extensive knowledge and skills to achieve this.

Some of the areas we cover are

Medicals

We see babies, children and adolescents on the wards, in accident and emergency and as outpatients. We develop individual chest management plans with the patient and families to help promote full recovery and reduce readmission into hospital. We work closely with the respiratory team.

We have many different skills to help us such as

  • Breathing exercises
  • Respiratory adjuncts
  • Postural drainage
  • Manual techniques
  • Exercise
  • Cough assist machine
  • Advice and education
  •  Relaxation

Who may need chest physiotherapy?

Babies/children or adolescents with

  • Recent abdominal or thoracic surgery and find it difficult to breathe and move
  • A chest infection
  • A long term respiratory condition such as asthma, bronchiectasis
  • Complex needs who are prone to chest infections
  • Panic attacks

Your physiotherapist will provide you with an information sheet

What else do we do?

We also help to physically rehabilitate children and adolescents who have had an acute admission or who have longer inpatient stays such as oncology. This can be done on the ward or in our physiotherapy department where we have access to hydrotherapy and the gym. We work closely with the patients and families to develop shared goals aimed at restoring function and improving quality of life.

Two of our Respiratory Physiotherapists Amanda Reed and Claire Shaw co-authored the respiratory symptoms chapter in The Oxford Textbook of Paediatric Palliative Care for Children.  This book won the Paediatric Category of the BMA Medicine Book awards 2013.

Please click here for further information on the respiratory department.

FAQs

If my child has come into hospital should I bring their Airvo/ Cough assist machine/ Ventilator/ Respiratory adjunct in with them?

Yes. The equipment is specific for your child. If it has not been brought in during the hospital stay, you will be asked to go home and collect it.

If my child is admitted, do they also receive their usual stretches that they have at home?

No. For an acute hospital stay unfortunately we do not have the provision for that service. Stretches would be expected to be completed by the family/guardian/carer as required. However if your child is in hospital for a longer period of time, the neurological physiotherapy team would assess and give advice accordingly.

Should my child continue to exercise after leaving the hospital?

Yes. Exercise has many benefits and we promote active lifestyles.

The lifestyles gyms provide free membership for under 17 year olds for one month, and £1 for each subsequent visit. Please visit the lifestyles website for further information.

 

Critical Care

Our Paediatric Intensive Care Unit (PICU) is a 23 bed unit and a designated Lead Centre. We care for children from all specialties including cardiac surgery, neurology and neurosurgery, burns, trauma infections, shock and oncology. The unit accepts over 1000 admissions per year and is one of the largest PICU’s in Europe.

Our unit is modern and provides all forms of therapy including High Frequency Oscillation, cardiac and respiratory ECMO, haemofiltration and Nitric Oxide, providing care for level 4 intensive care children. The physiotherapy team provides a pivotal role in the treatment of these patients.

In addition to PICU we have a 15 bedded High Dependency Unit (HDU), an 8 bedded Cardiac HDU and a 6 bedded Neurosurgical HDU. Our Physiotherapy team are instrumental in the set up and use of acute non- invasive ventilation and education throughout the hospital and further afield.

Our critical care physiotherapy team assesses all patients that come to PICU and HDU. We aim to help maintain clear airways whether patients are breathing independently, requiring some support or ventilated and ensure they have the means of clearing their own airways once the ventilation tube is out. Early rehabilitation is commenced whilst on PICU / HDU and will involve working with the nursing staff, parents and carers to provide passive movements, an active exercise programme and splints if required. If the child moves from Critical Care we will follow up their care on the ward, and will be involved with further rehabilitation as indicated.

Please visit the Intensive Care Unit website for further information

Both of our Clinical Specialist in Critical Care Vanessa Compton and Paul Ritson, are actively involved in research and audit centered at improving patient care and management.

Paul Ritson has authored chapters in Respiratory Physiotherapy: An On-Call Survival Guide, (Essential Facts at Your Fingertips).

 

Cystic Fibrosis

There is a Cystic Fibrosis (CF) team based at Alder Hey who work in conjunction with local CF teams at 12 district general hospitals across the North West, North Wales and the Isle of Man.

Our role for children and young people with cystic fibrosis and their families and carers is to educate and advise them about airway clearance and exercise.  We will teach you about the different techniques and equipment that can be used, then help you to manage your day to day treatment dependant on your activity level and whether or not you have any symptoms.Please see our physiotherapy in CF booklet and our parent information booklet.

You will see a physiotherapist regularly in clinic and in addition, we can visit you at home or you can have an outpatient appointment in the physiotherapy department.

Statistics:       85 children with CF are at Alder Hey

280 children with CF are across the region

Physiotherapy Equipment in CF

Exercise

We introduce CF babies to exercise straight away and will encourage you to participate in a range of activities as you grow up depending on what you enjoy!!

This could be Swimming, jogging, horse riding, football, dance, trampolining and many more!

Physiotherapy and research in CF

We are a regional CF centre and participate in and run many research trials, so you may be asked if you would like to be involved.  This helps us to improve CF care for people with CF around the world.

Pam McCormack regularly presents the work we have been involved in at international CF conferences and here is a list of some of her published papers and presentations.

Additionally, the Cystic Fibrosis Trust is a UK charity that deals with all aspects of cystic fibrosis.

Long Term Ventilation

99We have an established long term ventilation team with an expanding caseload of patients within the North West region. Our service is constantly growing and developing and we currently have 101 patients on LTV and 75 children who have face mask ventilation (NIV) and 26 children who have tracheostomy ventilation. Amanda Reed is the clinical specialist physiotherapist who sets up patients on NIV, helping the child to choose the most comfortable face mask and get used to being on a ventilator overnight while they sleep. Also supporting the family, carers and other staff in the process.

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