Smoke inhalation catastrophe reveals vital role of physiotherapists

^{Kirsty Jerrard (left) and Sian Evans with the poster they presented at the Intensive Care Society’s conference}

Unusually for them, paediatric respiratory physiotherapist Sian Evans and critical care respiratory physiotherapist Kirsty Jerrard worked side-by-side in June 2017. The event was so rare that they reviewed what had happened as a learning experience, to help them deal with anything similar in future.

Last December, they presented their findings at the Intensive Care Society’s annual conference in Liverpool where they spoke about the benefits they had brought to patients.

‘We had not previously come across this degree of smoke inhalation within our scope of practice,’ said Ms Jerrard. ‘And we wanted to make sure our treatment was appropriate and evidence based.’

Reallocating services

Over 14 days, they treated six patients – four children and two adults – who all had respiratory complications because of smoke inhalation. They contributed to the prevention of respiratory complications, such as infections, and a reduction in the number of days of intubation.

They achieved this through specialist respiratory assessments and treatment, including positioning of patients, sputum management and early rehabilitation. Physiotherapy interventions were tailored to the specific needs of individuals.

In addition, they reallocated services so that the six patients had physiotherapy day and night, and routine physiotherapy clinics were open as usual. ‘This was quite a fine balancing act,’ said Ms Evans.

A team effort

In total, the patients had nearly 100 physiotherapy interventions. Ms Jerrard said it was key to make sure that all therapists were aware of the respiratory complications they might encounter. It had been important to make sure physiotherapy was delivered without delay too, she said.

In conjunction with their departmental manager, they contacted local burns and trauma centres to get their help in finding relevant literature and protocols about physiotherapy treatment for smoke inhalation.

‘We are both proud to work at King’s and privileged to have treated these patients,’ said Ms Evans. ‘But we acknowledge our physiotherapy colleagues in other hospitals who helped us during this critical time.’

They agreed that caring for the six patients had been a team effort. ‘The resilience and professionalism of everyone at King’s was overwhelming,’ said Ms Jerrard.