Professor Brendan Cooper
Consultant Clinical Scientist at the University Hospitals Birmingham on behalf of the Association for Respiratory Technology and Physiology (ARTP)
Behind the images of “donned” healthcare professionals has been an army of inspiring respiratory physiologists who have changed their roles to fight COVID-19 on the front line.
“I’d like you to take a deep breath in… right in and…blow! Keep blowing… keep blowing, keep going, right out… just a little bit more… and… relax!” These words are uttered by respiratory physiologists thousands of times daily in the UK.
This is spirometry, the basic lung function test that indicates normality from abnormality, detecting asthma, COPD or lung fibrosis and is the gateway measurement to many lung disorders.
There is something in the air
The 3,000 respiratory physiologists, trained from degree to doctorate level, provide most breathing tests investigating the state of the airways, lung size and the efficiency of gas exchange by testing the breathing system during rest, sleep and exercise. Largely unknown to the public, they mainly work in hospital outpatient departments. However, they have undergone a meteoric change in their roles as the result of COVID-19.
One consequence of the pandemic was the reduction of routine diagnostic services and outpatient activity, but respiratory physiologists weren’t idle.
Firstly, a skeleton service was continued under stringent infection control procedures. This is because COVID-19 is an airborne vector and lung function testing is effectively an aerosol-generating procedure often inducing coughing and mass viral spread. Many services continued pre-operative testing for urgent requests such as lung cancer and fibrosis.
One consequence of COVID-19 was the reduction of routine diagnostic services and outpatient activity, but respiratory physiologists weren’t idle.
A blow out in the car park
Secondly, because of decreased outpatients, innovative delivery included car spirometry, home remote monitoring and rapid room ventilation to clear the diagnostic backlogs. Physiologists, in full PPE in hospital car parks, performed testing through the windows of family hatchbacks. Some services used smart disposable spirometers to enable self-testing at home using smartphones.
Critical caring
Finally, COVID-19 is a respiratory disease, so senior physiologists were deployed to COVID-19 wards/ITUs to deliver ventilation and oxygen 24/7. Inpatients had no visitors; physiologists provided kindness, caring and moral support to sick and lonely patients. They are now established as “clinical reinforcements” in hospitals during “winter pressures.” Innovative diagnostics are now embedded into routine services, enabling more community-based diagnostics and reducing the huge diagnostics backlog, using these incredibly hard-working teams.“Taking a deep breath” after the pandemic has a whole new meaning for respiratory physiologists.
