Five-year-old Sam is on long-term ventilation (LTV) at home and lives with his parents and 8 old year sister at home. He developed a chest infection five days ago and was admitted to PICU. To optimise his ventilation during this deterioration, his breathing was changed to a PICU ventilator via his long-term tracheostomy.

Airway: Tracheostomy in situ. Patent and secure.

Breathing: Mechanically ventilated on his usual ventilation mode and pressures. He is awake enough to trigger his own spontaneous breaths on the ventilator. The current plan is to transition him onto his own ventilator to normalise him.

Here are the details of his breathing assessment:

Total respiratory rate: 35/min

FiO2: 0.25

SpO2: 97% on above FiO2

EtCO2: 5.8kPa (normal range)

Arterial blood gases: normal pH and gases on current level of oxygen.

Secretions: very large, creamy, thick. Not reached his baseline normality as he continues to require frequent suctioning. His cough is weak.

On PICU he requires frequent chest physiotherapy, regular positioning to mobilise secretions and hourly suctions.

• What additional guidelines should you refer to when checking Sam’s bedspace?