Lung Disease Discharge Planning
|Reviewed by Simon Rowley
for Referral to the Respiratory Service
The Respiratory Service are
keen to be involved where at discharge:
- Severe clinical disease (marked
respiratory effort, indraw etc).
- Severe chronic lung disease on chest
- Requiring more than 250ml/min of oxygen.
- Right ventricular hypertrophy on ECG
wave in V1 and V2 >20mm
- RSR’ pattern in V1 with R > R’
- Positive T wave in V1
- Right axis deviation
- Babies without these criteria and who
are expected to require home O2 briefly, need not be
Assessment For Infants Going Home on
- Overnight oximetry with
printout, preferably current but also two weeks prior to establish
- Early morning capillary
- Current chest radiograph.
- Growth chart.
- Social Work/Homecare or
Family Liaison Nurse assessment, usually including a home visit.
- Interim summary of
There will usually be a
pre-discharge planning meeting approximately two weeks prior to
discharge in order to set a discharge date.
This meeting should
include an invitation to the Respiratory Nurse Specialist, General
Practitioner, the Consultant Respiratory Paediatrician, Dietitian, other
NICU staff including the Neonatal Consultant, Family Liaison Nurse,
Visiting Therapist, Social Worker etc as appropriate.
Consultant may choose not to attend or become involved at this stage if
the risk factors for severity are not
present (that is, if we
anticipate the baby will have minimal problems and come off oxygen
relatively quickly following discharge).
Infants will be not be considered for discharge if they have poor
feeding, poor growth, frequent desaturations, instability with feeding.
Infants being considered
for discharge should have had 10 days stability on NICU or PIN.
Infants who have just
come off oxygen should also fulfil these criteria if being discharged.
Follow-Up for the Infant on Oxygen
for severely affected infants or other infants whose progress is not as
expected once discharged
The Homecare Nurses
will visit weekly or according to need.
See the guideline for management of
infants on home oxygen.