Improved Respiratory Support in Remote Settings for Children: A Paediatric Acute Respiratory Intervention Study (PARIS), PARIS on Country

The next phase of studies, titled "Paris on Country," represents a continuation of efforts in Australia and New Zealand to enhance care for infants and children presenting with acute respiratory issues in emergency departments. Through these studies, we have successfully implemented changes in treatment protocols, aimed at alleviating respiratory distress and reducing anxiety for both patients and their parents.
In rural and remote areas of Queensland, approximately 38 percent of the state's total population resides. However, access to healthcare and emergency services in these areas can significantly differ from urban regions. The primary goal of this project is to elevate the standard of care for children experiencing acute respiratory distress in remote and regional settings to match the level of care available in larger cities.

Implementation of Nasal High Flow: A Remote Context

In this study, the clinician-researchers are exploring whether nasal high flow (NHF) therapy can be safely and effectively used to improve health outcomes for infants with bronchiolitis in isolated remote communities, in particular for remote Indigenous Australians who have a higher incidence rate of bronchiolitis than non-Indigenous Australians. There is a desire by clinicians to implement NHF in remote areas, but this should undergo similar scientific scrutiny as previous published data.

NHF is a respiratory support system that provides support for people with respiratory conditions and is applied by high flow oxygen through nasal prongs. The therapy can avoid an escalation of care during hospitalisation. The safety of NHF has been widely studied in tertiary areas and regional hospitals, however, there is a lack of evidence to support safe use in remote settings.

In this study, the researchers are employing a two-phased approach: Firstly, an expert working party establishing agreed safe clinical boundaries for the NHF implementation and utilising expert viewpoints for implementation when managing infants with bronchiolitis. Secondly, a comparison of the outcomes before and after implementation to observe a reduction in escalation of care leading to reduced transfers. A community engagement process, with the focus to keep community members in their country/home environment, will be established to measure psychological, social-emotional and economic benefits of NHF.