or care plan or management plan in place to reduce the risk of aspiration. Episodes of acute breathlessness, which do not respond to Moderate and need specialist-recommended input; or intermittent or continuous low-level oxygen therapy is needed to prevent secondary health issues; or supportive but not dependent non-invasive ventilation which may include oxygen therapy which does not cause life-threatening difficulties if disconnected; or child or young person has profoundly reduced mobility or other conditions which lead to increased susceptibility to chest infection (Gastroesophageal Reflux Disease and Dysphagia); or requires daily physiotherapy to maintain optimal respiratory function; or requires oral suction (at weekly) due to the risk of aspiration and breathing difficulties; or has a history within the last to six months of recurring aspiration/chest infections. Requires high flow air / oxygen to maintain respiratory function High overnight or for the majority of the day and night; or is able to breath unaided during the day but needs to go onto a ventilator for supportive ventilation. The ventilation can be discontinued for up to 24 hours without clinical harm; or requires continuous high level oxygen dependency, determined by clinical need; or has a need for daily oral pharyngeal and/or nasopharyngeal suction with a management plan undertaken by a specialist practitioner; or stable tracheostomy that can be managed by the child or young person or only requires minimal and predictable suction / care from a carer. Has frequent, hard-to-predict apnoea (not related to seizures); Severe or severe, life-threatening breathing difficulties, which require essential oral pharyngeal and/or nasopharyngeal suction, day or night; or a tracheostomy tube that requires frequent essential interventions (additional to routine care) by a fully trained carer, to maintain an airway; or
or care plan or management plan in place to reduce the risk of aspiration. Episodes of acute breathlessness, which do not respond to and need specialist-recommended input; or intermittent or continuous low-level oxygen therapy is needed to prevent secondary health issues; or supportive but not dependent non-invasive ventilation which may include oxygen therapy which does not cause life-threatening difficulties if disconnected; or child or young person has profoundly reduced mobility or other conditions which lead to increased susceptibility to chest infection (Gastroesophageal Reflux Disease and Dysphagia); or requires daily physiotherapy to maintain optimal respiratory function; or requires oral suction (at weekly) due to the risk of aspiration and breathing difficulties; or has a history within the last to six months of recurring aspiration/chest infections. Moderate Requires high flow air / oxygen to maintain respiratory function overnight or for the majority of the day and night; or is able to breath unaided during the day but needs to go onto a ventilator for supportive ventilation. The ventilation can be discontinued for up to 24 hours without clinical harm; or requires continuous high level oxygen dependency, determined by clinical need; or has a need for daily oral pharyngeal and/or nasopharyngeal suction with a management plan undertaken by a specialist practitioner; or stable tracheostomy that can be managed by the child or young person or only requires minimal and predictable suction / care from a carer. High Has frequent, hard-to-predict apnoea (not related to seizures); or severe, life-threatening breathing difficulties, which require essential oral pharyngeal and/or nasopharyngeal suction, day or night; or a tracheostomy tube that requires frequent essential interventions (additional to routine care) by a fully trained carer, to maintain an airway; or Severe
CCHC-referral-form-December-2016.docx