KNH free HOME OXYGEN PROGRAM ADIL WARIS

KNH free HOME OXYGEN PROGRAM ADIL WARIS

SPECIAL THANKS Monica Saulo respiratory nurse raised no fee for first 4 months Sheena began program together pays for all oxygen refills Family late Munir Diwan sponsors all nursing visits Medispec kenya ltd donated concentrator/ at cost/ services Parents of Zahra donated concentrator Nina Thakker donated concentrator Parents of Mohamed due to donate 2 concentrators

SCOPE OF PROBLEM Four wards 2-5 children Long stay in hospital Loss of one parent at hospital usually mother

KNH FORM Name of child Age Hospital registration number Ward Indication for home oxygenation Oxygen prescription Use nasal prongs/face mask at litres/minute for hours per day. Name and signature of consultant Information for the patient/home caregiver Ensure you have been given the main oxygen tank and a smaller one for back up or travel and the spanner to change the unit and the tubings for oxygen to reach your child. Ensure that you know how to change from one tank to the backup this is important. Safety Oxygen is a fire hazard: do not let anyone smoke in the house keep away from flammable liquids eg kerosene, alcohol, cleaning fluid or aerosols keep oxygen at least six feet away from flames or any heat sources eg jikos, candles, cookers, radios, TV, fan do not cook in the same room as the oxygen unit At home keep oxygen cylinders upright and in their cart at all times and do not allow them to roll or fall including during transport. Do not allow children or unauthorized persons to handle the oxygen units.

KNH FORM How do I replace my oxygen tank? When the pressure regulator reads red (at the number 50) on your bigger tank, connect the smaller tank to the patient and immediately call the emergency contact below. Emergency contact: Virginia 0722 627 768 I parent /guardian of have understood that oxygen tanks are a fire hazard and that I undertake to call for the oxygen backup on time and that the responsibility of this lies in my hands and not on the hospital or the ward consultant. Name of parent Signed Date

Home visits Day one, 14, monthly What we monitor

TYPES OF OXYGEN DELIVERY Tank 35k deposit and 1.5 k for refills Concentrator 85 k Portable concentrator 300 k Invertor added 30k but very bulky

Total no.of children sent on home oxygen is 7 children. Discharge from home oxygen therapy is 2 children. Deaths while undergoing treatment is 1 child.

1 ] NAME ;MM AGE:11YEARS SEX:MALE DOA:5/6/2017 DOD:21/8/2017 Hospital stay = 76 days Dx PTB,/CHRONIC LUNG DISEASE/IDIOPATHIC BRONCHOECTASIS. HOME LOCATION: MAJENGO SLUMS IN EASTLEIGH DURATION OF HOME OXYGEN 240 DAYS Child doing well on home oxygen via electrical oxygen concentrator and back up oxygen cylinder on O2 2 to 4lt/min of oxygen SPO2 91% physiotherapy done by mother On monthly follow up buy Dr Waris and home visits, Has had fire breakout at their surrounding but home has not been affected, only blackouts.

2]NAME;Y N AGE:6 YRS SEX:MALE DOA:29/5/2017 DOD:11/10/17 Hospital stay = 131days Dx: BRONCHIECTASIS/CHRONIC LUNG DISEASE/RVD HOME LOCATION:KASARANI. DURATION OF HOME OXYGEN 202 DAYS Child is doing well on home concentrator and back up oxygen at 1 to 2 l/min of oxygen SPO2 above 93%, has been admitted twice due to fever in regards to CD4 counts, but currently at home doing well. MDR TB DIAGNOSED whilst at home!! monthly follow up dr waris and home visits done.

3]NAME:L W AGE:2YRS SEX:FEMALE DOA:16/5/17 DOD:16/10/17 Hospital stay = 155 days Dx: INTERSTITIAL LUNG DISEASE HOME LOCATION:JERICHO,JOGOO ROAD DURATION OF HOME OXYGEN 177 DAYS Post discharge has been wean off O2 slowly and tolerating the changes. On follow up by Dr Waris and monthly home visits.

4]NAME;J G AGE:10YRS SEX:MALE DOA:22/9/17 DOD:2/11/17 Hospital stay = 38 days Dx: SEVERE PAH(CCF)/KYPHOSCOLIOSIS/CELEBRAL PALSY HOME LOCATION:LIMURU(IN A VILLAGE) DURATION OF HOME OXYGEN 167 DAYS Child is doing well was on back up cylinder and concentrator initially then electrical concentrator was connected to solar battery and electricity On follow up at the cardiac clinic at KNH and monthly home visits.

5]NAME:P T AGE:9YRS SEX:MALE DOA17/8/17 DOD27/11/17 Hospital stay = 101 days DATE OF DEATH: JANUARY 2018 Dx; INTERSTITAL LUNG DISEASE HOME LOCATION: WANGIGE,KIKUYU DURATION OF HOME OXYGEN 60 DAYS Child was discharge home in stable condition on oxygen at 2l/min on cylinders,was doing well in January severe pneumonia and significant transfusion delay Patient passed away in KNH

6]NAME:Z M AGE:7 MONTHS SEX: MALE Dx: PREMATURITY Hospital stay = 207 days Prematuriy at 28 weeks, transferred to KNH because of prematurity and oxygen dependence, at 7months was discharged on home oxygen DURATION OF HOME OXYGEN 1 HOUR but reaching home and doing assessment for 4 hours child didn't require oxygen, visits were done on day 5,15 assessment done and concluded patient was not in need of oxygen

7]NAME:B N AGE:1YRS SEX:MALE Hospital stay =?? days DX: PULMONARY HTN/CARDIAC DIEASE HOME LOCATION:KAWAGWARE 56,SLUM AREA DURATION OF HOME OXYGEN 48 DAYS Child was discharged from home oxygenation Assessment was done after several home visits and weaned off all oxygen Child is doing well

Difficulties encountered Residence burnt down Not using oxygen always.. Need for oximeters Cant refill out of Nairobi Invertor heavy Difficult access to slums Cheaper Chinese concentrator with battery backup and car charger stopped working midway with a patient