The department provides a tertiary level consultative and management service primarily to the Queensland Health Southern zone but with extension to the whole state of Queensland and northern New South Wales.
Clinical areas of service of the department can be divided as follows.
Cystic Fibrosis
The multidisciplinary approach comprises paediatricians, general paediatricians, paediatric gastroenterologists, clinical nurses, dieticians, physiotherapists, occupational therapists, social workers, liaison psychiatry registrars from child and adolescent mental health and a school teacher from education.
Close association exists with endocrinology, ENT and Queensland genetic services. The clinic is the smaller of the two tertiary paediatric CF services in the state with an average of 70 patients. An adult service for the southern zone of Queensland health exists at Mater Adult hospital of approximately 50 patients and offers the opportunity of improved liaison for patient transfer to adult facilities.
CNLD Home Oxygen and Home Tracheostomy Service
The service averages 50 active patients on home therapy with the majority being ex-premature infants. Care is on a share care basis with general paediatrics both regional and within the hospital. Referrals are received from the state and northern NSW with the majority being referred initially from Mater Mothers' Hospital neonatal unit. Mater Mothers' Hospital is one of the largest birth hospitals in Australia with 7600 births per year. The neonatal unit has 20 ventilator beds and 20 high dependency beds.
The multidisciplinary team includes respiratory paediatricians, clinical nurses, physiotherapists, occupational therapists, speech pathologists, dietetitions and social workers. Close liaison exists with the Growth and Development clinic, developmental paediatrics and paediatric surgery.
Sleep Disorders
The sleep unit provides a diagnostic, consultative, teaching and therapy-based service in the area of sleep related respiratory, behavioural, neurological and sleep phase disorders. The unit has been operating for over ten years and receives referrals from the whole state of Queensland and northern New South Wales.
The investigatory side of the clinic is associated with a four-bed polysomnography unit—the only tertiary level paediatric sleep investigation unit for the state of Queensland. Both respiratory and non-respiratory sleep disorder referrals are accepted, with an emphasis on respiratory causation. Management and investigation is in conjunction with neurology, child psychiatry and developmental paediatrics.
This service instigates and co-ordinates a home ventilatory support service with patients from Queensland and northern New South Wales—at present over 70 patients are managed on home nasal mask ventilatory support (CPAP and bi-level pressure support).
Polysomnography Laboratory
Four beds with full digital polygraphic acquisition (up to 32 channels), two of which have synchronised digital videos. The facility performs 550+ full polysomnograms per year. The patients are cared for during the study on a one to one basis by paediatric RN's who are skilled in real time scoring of the acquired data. Three of the RN/techs have achieved registration from the BRPT USA.
The unit is eligible for accreditation for training of paediatric sleep medicine under the guidelines of the Thoracic and Sleep Medicine SAC for the RACP. A full-time sleep scientist manages the laboratory.
Lung Function Laboratory
This is a joint service with adult and paediatrics (70% of tests preformed are paediatric). The laboratory is able to perform static volumes, real time flow loops, closing volume and diffusion measurements, maximum inspiratory and expiratory pressures, bronchial provocation and skin allergy testing and full cardiopulmonary exercise testing with treadmill or bike. The lab is equipped with a Sensormedics Vmax 22 incorporating a Vmax 62 Autobox, Sensormedics Vmax 229D CPE system and Sensormedics 2600 paediatric pulmonary cart. A full-time senior scientist manages the laboratory.
Flexible Bronchoscopy Service
For the investigation of upper and lower airway anatomical lesions and for obtaining bronchial airway lavage specimens in infants and children. The hospital has three 3.5 mm and 4.6 mm bronchoscopes and one ultra fine 2.6 mm flexible bronchoscope, all with video imagining. There is a second weekly designated operating theatre time for routine procedures. Emergency procedures are facilitated on an as needs basis. The full-time paediatric anaesthetics have extensive skills in the management of the airway and ably facilitate the procedures.
Teaching
Medical students from the post-graduate medical school (Southern Medical School, University of Queensland), junior medical staff training for higher qualifications in paediatrics, nursing and allied health staff in basic and post-graduate degrees all form part of the teaching areas of the department. Active involvement in in-house, regional and national education programs for colleagues and general practitioners is facilitated.
Research
The Department of Respiratory Medicine enjoys close collaboration with the Paediatric Respiratory Research Centre which is independently funded and offers clinicians in the department the opportunity to participate in laboratory-based research. The centre is staffed by the director, a senior research officer, two research assistants and a half-time secretary. It is formally affiliated with the Department of Medicine of the University of Queensland. The focus of research at the centre is surfactant, with a particular interest in its application to asthma, otitis media, SIDS and fluid retention in neonates following “surfactant rescue”. Other clinical aspects of SAPL studies for its barrier and lubricating properties include surgical adhesions, osteoarthritis and peptic ulcer as funded by commercial sources. Currently seven clinical trials are under way. The centre has an excellent publication record with many papers arising from collaboration with the Department of Respiratory Medicine.
Collaborative research also occurs with the bio-medical engineering department of the University of Queensland's Dr Steven Wilson on innovative telemetry techniques and improved sensors in use in polysomnography and screening investigations. The environment exists to extend this area of research.
Staff
Medical personal includes three respiratory paediatricians, two paediatric respiratory training fellows, a paediatric registrar on four monthly rotation and a paediatric junior medical officer on a two-monthly rotational. There is close association with all units within the hospital, with the following clinicians offering direct clinical support to clinics, a developmental paediatrician, a paediatric psychiatrist and two paediatric psychiatry registrars and a paediatric neurologist. The scientific staff comprise a paediatric sleep scientist, a senior respiratory scientist and a biomedical engineer.
The nursing staff comprises a clinical nurse consultant unit manager, six clinical nurses and six registered nurses who manage the specialty home care patients and perform the polysomnography.
There are three administrative personnel who support the unit.