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KNH free HOME OXYGEN PROGRAM

This program aims to provide home oxygen therapy to children in need, ensuring their access to continuous oxygen supply. With the support of donors and healthcare professionals, we are meeting the respiratory needs of these children and improving their quality of life.

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KNH free HOME OXYGEN PROGRAM

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  1. KNH free HOME OXYGEN PROGRAM ADIL WARIS KPA 2019

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

  3. SCOPE OF PROBLEM • Four wards … 2 - 5 children • Long stay in hospital • Loss of one parent at hospital usually mother • Initially 6 months in KNH • Now down to 1 month • We are meeting the needs of the children

  4. 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 egjikos, 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.

  5. 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 _______________

  6. Home visits • Day one , 14, monthly • What we monitor

  7. 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

  8. Total number of children sent on home oxygen is 14 children. • Discharge from home oxygen therapy is 5 children. • Deaths while undergoing treatment is 3 child.

  9. 1 ] NAME ;MM • AGE:11YEARSSEX:MALE • DOA:5/6/2017DOD:21/8/2017 Hospital stay = 76 days • Dx PTB,/CHRONIC LUNG DISEASE/IDIOPATHIC BRONCHOECTASIS. • HOME LOCATION: MAJENGO SLUMS IN EASTLEIGH • DURATION OF HOME OXYGEN 388 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 by Dr Waris and home visits, • Has had fire breakout at their surrounding but home has not been affected, only blackouts.

  10. 2]NAME;Y N • AGE:6 YRS           SEX:MALE • DOA:29/5/2017DOD: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 drwarisand home visits done.

  11. 3]NAME:L W • AGE:2YRS            SEX:FEMALE • DOA:16/5/17DOD:16/10/17 Hospital stay = 155 days • Dx: INTERSTITIAL LUNG DISEASE • HOME LOCATION:JERICHO,JOGOO ROAD • DURATION OF HOME OXYGEN 377 DAYS • Post discharge has been wean off O2 slowly and tolerating the changes. • On follow up by DrWaris and monthly home visits.

  12. 4]NAME;J G • AGE:10YRS              SEX:MALE • DOA:22/9/17DOD:2/11/17 Hospital stay = 138 days • Dx: SEVERE PAH(CCF)/KYPHOSCOLIOSIS/CELEBRAL PALSY • HOME LOCATION:LIMURU(IN A VILLAGE) • DURATION OF HOME OXYGEN 488 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.

  13. 5]NAME:P T • AGE:9YRS   SEX:MALE • DOA17/8/17DOD27/11/17 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,wasdoing well • in January 2018… severe pneumonia and significant transfusion delay • Patient passed away in KNH

  14. 6]NAME:Z M • AGE:7 MONTHS • SEX: MALE • Dx: PREMATURITY Hospital stay = 207 days • Prematuriyat 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

  15. 7]NAME:B N • AGE:1YRSSEX:MALE Hospital stay = ?? days • DX: PULMONARY HTN/CARDIAC DIEASE • HOME LOCATION:KAWAGWARE 56,SLUM AREADURATION 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

  16. Difficulties encountered • Residence burnt down • Not using oxygen always.. Need for oximeters • Cant refill out of Nairobi • One concentrator spoil by SOUP used as table

  17. Difficulties encountered • Pressure regulators break if you play soccer • Invertor heavy • Difficult access to slums • Cheaper Chinese concentrator with battery backup and car charger stopped working midway with a patient

  18. AGA KHAN EXPERIENCE • Average of 1-2 per month past 10 years • Preterms with birth complications majority • Syndromic babies with pulm hypertension • Concentrator … portable with invertor /cylinder backup • Easier to followup and contact etc

  19. UPDATE FROM LAST YEAR • 3 CHILDREN HAVE CROSSED THE ONE YEAR MARK • ONE NOW ATTENDS SCHOOL • 3 PARENTS ARE NON COMPLIANT ON OXYGEN USUALLY THOSE WITH HIV…. Maternal neurosis • MORE REQUESTS FROM ADULT PULM • MORE PATIENTS WITH DOWNS • DR DIANA HAS JOINED THE TEAM ACTIVELY • PUBLIC PRIVATE PARNERSHIP WORKING

  20. LAST WORDS • Just because the saturations are 94% does NOT mean we don’t need oxygen • Children grow better and thrive when oxygen needs are met

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