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If a patient is referred for evaluation of possible sleep apnoea with sleep disturbance, excessive daytime sleepiness/tiredness, loud snoring or concerns about irregular night time breathing patterns, then a standard protocol is followed. An initial detailed medical consultation is arranged. During that visit, a full history and examination, preferably with an accompanying partner (although not essential), are performed with specific questionnaires, and if necessary a sleep diary for review.
The next stage is usually an overnight sleep study. This may be as an inpatient or at home.The results are analysed, and this report together with other investigations are discussed at a follow up appointment. At this stage, the diagnosis is usually available, and treatment with a device &/or other management strategies are discussed and arranged. Occasionally, sleep studies require repeating for reasons of technical quality assurance. Furthermore, certain other investigations that are important for health may be undertaken.
Critical illness, by definition, requires a higher level of care, usually in an intensive care unit, high dependency unit or intermediate care facility. The role of the specialist in critical care is both as a diagnostician and to manage the patient through the illness, utilising a specific set of knowledge and practical skills, particular to intensive care.
The conditions may be respiratory failure, sepsis, cardiac complications, acute medical illness or post operative/procedure related complications, As a specialist in intensive care and respiratory medicine, i am frequently asked to, and do consult and look after many patients whose medical care requires a step up to a higher level as a result of deteriorating illness or complications.
If a specialist opinion is required in patients with acute medical or surgical illness, that requires advice from the critical care perspective, particularly if respiratory,ventilatory or sepsis-associated features are apparent, then we offer such an opinion. Second opinions are provided as required with appropriate permissions.
For further information please contact us through the number on the website or 02087468063.
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