Home ventilation: need a user support number?

C ontemporary homes can include a number of electrical devices aimed at making life easier, such as washing machines, dishwashers and vacuum cleaners. One can also find devices aimed at improving lifestyle, such as exercise bicycles or rowing machines. However, one can also find other types of devices that are aimed at supporting or saving people's life. These can include continuous positive airway pressure machines, home dialysis machines, oxygen concen-trators and home respirators. All these devices have electrical plugs, knobs, switches, light bulbs, LEDs and screens. However, the manipulation of these devices is not at all similar, and the interactions between the devices and the users have quite different meanings. Despite the obvious differences between these machines, it remains true that a malfunctioning washing machine or a malfunctioning respirator will require a similar reaction: call the user support number. Respiratory physicians do not have a long tradition of home life support treatment and every piece of information concerning this issue is worth learning. In the present issue of the European Respiratory Journal, CHATWIN et al. [1] present data on the call centre they established to support more than 1,000 patients on home respirators. The Respiratory Unit of the Royal Brompton Hospital (London, UK) serves a vast geographical area. In order to allow patients to reach them, they established a communication protocol based on telephone numbers patients can call day and night in case they need to or they feel they need to. These calls can be made for a number of reasons; from simple concerns such as asking for spare part replacement, to more disturbing ones such alarms coming on during the night or to a respirator becoming noisy all of a sudden, to very serious ones such as a respirator breakdown in a respirator dependent patient. CHATWIN et al. [1] have recorded and analysed all calls received during a 6-month period, from a population of 1,211 patients, from paediatrics to geriatrics, who were followed up at their centre. All patients had had a training process within the Royal Brompton Hospital unit, and all patients or families were deemed able to understand the use of home respirators, adequately fit and assembly/disassembly the mask and interfaces, start and stop the machines, and even to unlock the settings in order to change them according to telephonic instructions if this was thought useful by the on-call personnel. A personalised information set was delivered …