Warrington Hospital leading the way in cutting COVID-19 death rates

A small dedicated team at Warrington Hospital appears to be leading the way in cutting COVID-19 death rates with ‘black boxes’ normally used for sleep disorders.

Clinicians at the hospital say there has been less need for more intrusive ventilators and they appear to be having a far quicker patient recovery rate.
Medics have modified devices known as “black boxes” which normally treat sleep apnoea – a condition when breathing stops and starts whilst sleeping.
One of the hospital’s consultants Dr Mark Forrest said they had started from “ground zero” in how to manage the pandemic in the area.

Dr Forrest told Sky News: “We watched very closely what was happening in other countries in particular Italy and learned from them.”
He said a small team of seven consultants and their respiratory colleagues quickly realised the ventilators were not the “magic bullet solution” to COVID-19.
The hospital only normally has access to 12 ITU (intensive therapy unit) ventilators.
At the same time, they realised using ventilators which requires a breathing pipe to be inserted down the throat, and requires the patient to be put under anaesthetic, had a relatively poor recovery rate. In some cases, it was only 50-50.
This realisation was in line with medics across the world who were also finding it was a long and difficult journey to bring a COVID-19 patients back to recovery from ventilation – and a journey which often didn’t result in survival.
The team made an early decision to try to avoid ventilation by switching to CPAP machines (continuous positive airway pressure) where the device pumps oxygen, under a constant pressure, into the lungs through a close-fitted face mask.
A team in the hospital’s respiratory department led by Dr Mithun Murthy, alongside consultant Saagar J Patel, realised the simple black boxes they used in their sleeping disorder clinic were built on the same premise as the much more sophisticated and expensive CPAP machine.
Dr Murthy said he believed the adaption of the simple device had probably been responsible for changing the lives and the medical outcome for hundreds of COVID-19 patients who’d passed through Warrington Hospital.
The boxes, which are considerably cheaper than the hospital versions and are simple enough for patients to use at home at night for typically a maximum of 12 hours.
Medics in the hospital’s intensive care unit (ICU) found by putting patients on the black boxes as soon as they arrived in the department stabilised quickly, avoiding ventilation.
“Often we were seeing positive reaction within 15 minutes,” said Dr Forrest.
The respiratory team at the hospital, working in close collaboration with their ICU colleagues, modified the boxes by fitting them with superior masks and linking them up to oxygen.

They first tested it on fellow members of staff before trying it on patients. “We really believed it would work. It was a case of having it confirmed,” said Dr Murthy.

So…just watched the Sky News headlines which led on @WHHNHS and some of the ingenuity and innovation shown to adapt equipment to help people stay out of critical care. Couldn’t be prouder of the professionalism and attitude of everyone 👏🏻👏🏻👏🏻

— Steve McGuirk CBE,DL (@WHHFTChair) April 23, 2020