The role of respiratory physiotherapists in the coronavirus response

NEWS - 13TH APRIL 2020

How Royal Brompton and Harefield Hospitals’ team of respiratory physiotherapists are caring for patients experiencing the effects of Covid-19

Royal Brompton and Harefield Hospitals’ team of respiratory physiotherapists are specialists in the field of breathing. Their role is to help patients who have underlying heart or lung conditions exercise safely, provide rehabilitation following a long hospital stay, prescribe airway clearance regimes for those suffering recurrent chest infections or difficulty clearing their chest, and retrain patients’ dysfunctional breathing patterns. Patients who often benefit from their work include those with bronchiectasis, asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), asthma and other breathing disorders.

As Covid-19 affects the respiratory system, respiratory physiotherapists are currently playing a vital on the frontline, helping people in hospital and using digital platforms to support those unwell at home.

Their skills are of particular benefit in areas such as:

— Rehabilitation for those who have spent prolonged periods in intensive care on mechanical ventilation
— Weaning from mechanical ventilation
— Managing those with underlying lung conditions who contract Covid-19
— Providing rehabilitation for high-risk patients who will have been less active during the Covid-19 pandemic
— Managing those who now have lung disorders as a result of the virus
— Helping those with anxiety disorders, breathing pattern problems or hyperventilation syndrome as a result of the trauma

Emily Lockwood

Personalised treatment
London-based respiratory physiotherapist Emily Lockwood has worked at Royal Brompton Hospital for eight years. She explains: “My aim with all my patients is to provide personalised treatment which is based on the patient’s needs. Depending on their condition and presentation, my treatment may consist of airway clearance, breathing pattern assessment and re-education, pulmonary rehabilitation or individualised exercise input.”

She continues: “For Covid-19 patients, I anticipate there will also be a large need for specialist rehabilitation in the home to get patients back to their previous level of independence.”

Emily finds that her experience of working at a dedicated heart and lung hospital is highly valuable. “Quite often, I see patients who have co-existing or complex problems. It’s key to have a knowledge of how to best manage and treat such cases. Working with a team of extremely experienced colleagues where we all share knowledge certainly helps.”

Risk of complications
People who experience problems with their breathing, have an underlying respiratory condition or are prone to chest infections are at higher risk of complications from Covid-19. It is therefore important to maintain a healthy lifestyle, focusing on keeping the chest clear during the pandemic. There are several techniques that can help maintain good health:

— Performing airway clearance exercises. This must be performed daily to keep the chest clear of secretions and to ward off any infection while the virus continues to be a threat
— Staying as active as possible to maintain fitness levels
— Continuing to take prescribed medications
— Staying hydrated. Most health authorities recommend two litres of water daily. This does not include fizzy drinks, caffeinated drinks (tea/coffee) or alcohol