Auckland DHB Respiratory Services

Public Service, Respiratory

Description

What is Respiratory Medicine?

Respiratory medicine is the branch of medicine that treats people with diseases affecting the lungs and breathing.

The role of our lungs is to deliver oxygen into our bloodstream and remove carbon dioxide. When you breathe in, air passes through the throat into the windpipe (trachea). The base of the windpipe divides into the right and left tubes (bronchi) which divide again and again each time getting smaller and smaller until the smallest airways called the alveoli are reached. The alveoli act like balloons i.e. when you breathe in they inflate and when you breathe out they relax.

Oxygen moves across the walls of the alveoli and enters the bloodstream and is carried to the rest of the body after passing through the heart. Carbon dioxide is passed from the blood into the alveoli and is breathed out of the lungs.

Common symptoms or signs of lung disease include: shortness of breath, wheezing, long-term cough, coughing up blood, and having chest pains.

The Respiratory Department

Respiratory services provided by the Department consist of outpatient clinics, a day stay unit and inpatient (ward) care.

General respiratory outpatient clinics are held at Greenlane Clinical Centre but specialty clinics and tests e.g. sleep studies and bronchoscopy are held at Auckland City Hospital.

The Department is staffed by respiratory physicians (doctors who specialise in treating conditions of the lungs), specially trained nurses, technicians, physiotherapists, and registrars (doctors training to be specialists).

Consultants

Dr Sonia Cherian

Respiratory Physician
Dr Timothy Christmas

Respiratory Physician
Dr Sally de Boer

Respiratory Physician
Dr Adrian Harrison

Respiratory Physician
Dr Sandra Hotu

Respiratory Physician
Dr Syed Hussain

Respiratory Physician
Dr Clair King

Respiratory Physician
Professor John Kolbe

Respiratory Physician
Dr Chris Lewis

Respiratory Physician and Director of Prevocational Training
Dr Tanya McWilliams

Respiratory Physician
Dr Mark O'Carroll

Respiratory Physician
Dr Sasiharan Sithamparanathan

Respiratory Physician
Dr Kenneth Whyte

Respiratory Physician
Dr Margaret Wilsher

Respiratory Physician

Referral Expectations

If you have an urgent problem requiring immediate respiratory assessment you are referred acutely to the Respiratory Department where you will initially be seen by the Registrar (trainee specialist) in the Emergency Department at Auckland City Hospital. The registrar will decide whether you need to be admitted to hospital. Investigations will be performed as required, and the more senior members of the team involved where necessary.

If the problem is not urgent, the GP will refer you to the Respiratory Department requesting an appointment in the outpatient clinic. GPs - please use the CareConnect eReferral system to do so.

One of the consultant respiratory physicians working in the Department reviews these letters to determine who should be seen first, based on the information provided by the GP and the urgency of the symptoms. Very urgent cases are usually seen within a couple of weeks, but other cases may have to wait a longer time. Sometimes the specialist will need further information and we may write to you asking you to complete a questionnaire about your health problems. A decision will be made on how quickly you need to be seen and an appointment will be sent to you.

When you come to the Respiratory Outpatient Department you will be seen by a member of the respiratory team who will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one clinic visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before you are seen at the hospital to try to speed up the process.

Once a diagnosis has been made, the medical staff will discuss treatment with you. They will write to your GP with advice and may or may not arrange for you to attend a follow-up clinic.

You need to bring to your appointment:
1. Any letters or reports from your doctor or another hospital.
2. Any X-rays, CT (computer tomgraphy) or MRI (magnetic resonance imaging) films and reports.
3. All medicines you are currently taking, including herbal and natural remedies.
4. Your pharmaceutical entitlement card.

If you have any change in your condition before you come to your appointment, please see your GP immediately.

Procedures / Treatments

Asthma

Asthma symptoms include coughing, wheezing, a tight feeling in the chest and trouble breathing.… More
Chronic Obstructive Pulmonary Disease (COPD)

This term is used to describe lung disease where the breathing tubes become blocked and the surrounding tissue and air sacs inside the lungs become damaged.… More
Lung Cancer

This is when abnormal malignant cells divide and grow in an uncontrolled fashion in the lung tissue.… More
Lung Function Tests

You may be advised to take lung function tests to find out how much air moves in and out as you breathe.… More
Spirometers

Spirometry is a test which measures the speed at which your lungs can be filled and emptied of air. It can be used to diagnose problems of breathing and monitor the usefulness of treatment.… More
Peak Flow Meter

This is a small hand-held tube that can measure what is happening in your breathing tubes. You can have one at home and measure your peak flow by blowing into it as hard and fast as possible. You will be shown how to measure it and compare it with what… More
Blood Gas Tests

This is similar to a blood test but instead of a needle going into a vein it is inserted briefly into a small artery in your wrist. A small amount of blood is taken and sent to the laboratory for information about the oxygenation of your blood and other gases.… More
Chest X-ray

A chest X-ray is normally undertaken to check the chest wall, lungs and heart.… More
Computer Tomography (CT) Scan

With CT you can see much more detail than with a normal X-ray.… More
Fine Needle Aspirate

Depending on what is seen on the CT scan an additional test can be done where a fine needle is inserted into your chest into the cancer and some cells sucked up into the needle. This is done while taking pictures with the CT scanner to guide the doctor as… More
Bronchoscopy

During this test a thin fibreoptic tube is inserted into your breathing tubes, through the nose, to view the tubes.… More
Sleep Apnoea / Sleep Study

What is Sleep Apnoea?

While sleeping, all our muscles relax (go floppy and loose). This includes our throat muscles.… More

Document Downloads

Introducing ADHBSleep Patient Info Sheet (PDF, 503.9 KB)
Brief information for patients being referred to ADHBSleep
ADHBSleep OSA Patient Information Booklet (PDF, 2.2 MB)
Comprehensive patient information about OSA and ADHBSleep.
Healthy Sleep Hygiene & Drowsy Driver Tips (PDF, 382.9 KB)
Patient Information Sheets
Sleepiness & Driving Patient Info Sheet (PDF, 239.2 KB)
Covers recommendations and NZTA aspects of driver licensing for patients with excessive sleepiness, OSA, and CPAP therapy
Snoring Patient Info Sheet (PDF, 902.7 KB)
Brief advice for simple snorers not suitable for referral to ADHB Sleep Service
Insomnia Patient Info Sheet (PDF, 204.9 KB)
Brief advice for insomnia, produced by American Thoracic Society
Shiftwork Patient Info Sheet (PDF, 77.7 KB)
Brief advice for shiftworkers, produced by Sleep Health Foundation
Replacing CPAP machines and parts - Patient Info Sheet (PDF, 304.7 KB)
Guidelines for patients under the care of ADHBSleep requiring machine repair or consumable replacement
Restless Legs Info Sheet (PDF, 233.8 KB)
Brief information for Restless Legs Syndrome, produced by American Thoracic Society
Referring to ADHBSleep? (PDF, 354.9 KB)
Please ready this handy guide before considering referring patients to ADHBSleep