A Queensland researcher says too many children with respiratory infections are automatically transferred to major hospitals, when they could receive the same treatment in their rural or regional centre.
Around 20,000 children are admitted to hospital with acute respiratory issues every year in Australia, with 3,000 requiring intensive care admission, usually in a city hospital.
However a study led by Dr Andreas Schibler, a paediatric intensive care specialist from Brisbane, has demonstrated that a common type of respiratory support, usually provided to children in city-based intensive care units, can also be delivered in general wards in regional hospitals.
Dr Schibler and his team compared two methods of treating acute respiratory issues — nasal high-flow oxygen therapy and standard oxygen — in 1,500 children under 5 years old, across 14 hospitals.
"We know now that some forms, like the nasal high flow, is completely safe to be used in these regional and metropolitan hospitals," Dr Schibler said.
"This type of respiratory support can be provided in intensive care, as well as a general ward. So the question was, why can't it be done in a regional hospital?
"We needed to have solid data and research, to prove, is it safe, is it feasible, is it tolerated?"
He also said the research could help ease the burden on busy city hospitals.
Dr Schibler has been a paediatric intensive care specialist for three decades, but in recent years, has carried out Paediatric Acute Respiratory Intervention Studies, which have informed the research.
He said the research was about understanding when best to put a child on nasal high flow therapy as opposed to standard oxygen.
"There's two parts to it — equipment training, and upskilling the local staff," he said.
Keeping kids in their communities
Dr Schibler said the change would particularly help those who lived in remote parts of Far North Queensland, like seven-month-old Jenovia.
Jenovia lives with her mother Lily York in Napranum Aboriginal Shire, 950 kilometres north-west of Cairns, and had to be transferred to city's hospital the first time she had bronchiolitis.
"The first time, when I flew out to Cairns, I got no help — who was I going to call?" Ms York said.
But as part of research trials conducted by Dr Schibler and his team, Jenovia was treated for the infection at Napranum's health clinic.
It was a relief for her mum, who said being able to stay close to family and support systems had made a huge difference.
Trials aim to halve transfers
Dr Schilber said outside the trials, up to 50 per cent of children in Far North Queensland were transferred to Cairns or Townsville, but the aim of the research was to cut that in half.
"We've been able to show that we can keep these families in these [small] hospitals," he said.
The research is a collaboration with the Wesley Research Institute, Menzies Health Institute and Griffith University.
It has been published in the Journal of the American Medical Association and will be presented at the Society of Critical Care Medicine conference in San Francisco.
