2005 OPEN FORUM Abstracts
SURVEY OF HELIOX UTILIZATION IN SAN DIEGO COUNTY
Rebecca Handley1 RRT, Melissa K Brown1 RRT-NPS, Amy Robison2 RRT, David Willms1, 3 MD, 1Grossmont Community College, El Cajon, CA, 2San Joaquin Valley College, 3Sharp Memorial Hospital San Diego, CA
Background: Inhalation of heliox gas can reduce airway resistance, patient work of breathing, and the driving airway pressure required to achieve adequate ventilation. There is a generally accepted role for heliox in treating airway obstruction. Recently, heliox applications have expanded from asthma and airway obstruction to bronchiolitis and COPD. There is little information on the capability of local hospitals to deliver heliox therapy.
Methods: We surveyed RT Managers at 21 area hospitals in San Diego County and asked about their use of heliox therapy. Questionnaires were distributed at a local Respiratory Care Program Advisory Board meeting and through E-mail. Managers who did not reply were contacted by telephone. Responses from seventeen hospitals were analyzed. Results were tabulated and are reported as percentages or mean values where appropriate.
Results: Most (76%) of respondent hospitals in San Diego County have the capability to administer heliox; notably, hospital size does not appear to play a role. Overall, 17.2 ± 54 patients per year are treated at heliox-capable hospitals (range 1-224). Heliox is administered to non-intubated patients at 70.5% of the hospitals, and 11.8% administer heliox in conjunction with non-invasive positive pressure ventilation. Only 29.4% of the hospitals with the capability to administer heliox also administer heliox to ventilated patients. The Galileo ventilator (Hamilton Medical, Rhäzüns, Switzerland) was the most commonly reported preferred ventilator for heliox administration. All heliox-capable hospitals which service neonatal and pediatric patients also have ability to deliver heliox including through mechanical ventilators. Heliox tanks are available at all times at 90% of the hospitals that provide heliox therapy, and 88% of them stock either 80/20 or 70/30 tank mixtures. Heliox protocols or written instructions for heliox set-up are in place at 70.6% of the hospitals. For patients requiring emergent heliox therapy, participating hospitals report a mean time of 33.25 ± 24.8 min to begin therapy. Heliox is delivered in the ICU at a ratio of almost 3:1 over the ED and it is not routinely administered on the Acute Care floors at any San Diego hospital.
Conclusions: Most San Diego County hospitals have the capability to provide heliox therapy in a timely manner. However, a majority do not administer heliox to mechanically ventilated patients. This may due to lack of technical expertise or possibly lack of access to mechanical ventilators that will function properly with heliox. Results of this survey are not generalizable to other areas of the country.