Respiratory and Sleep Medicine

The Department of Paediatric Respiratory and Sleep Medicine provides a complete consultative, investigative and therapeutic service for infants, children and adolescents with a wide range of respiratory and sleep disorders.

Patient referrals are accepted from the Greater Newcastle, Hunter, New England, Central Coast and Northern NSW regions.

Inpatient services are exclusively undertaken at the John Hunter Children's Hospital. Patients are admitted mostly into the Children's Medical Ward and Adolescent Ward. Consultation services are also provided to patients in the Neonatal and Paediatric Intensive Care Units.

Specialist outpatient clinics are provided at the John Hunter Children's Hospital and Maitland Hospital with annual clinics held at Armidale and Tamworth Hospitals. These include both medical specialist clinics and clinical nurse consultant lead clinics (specifically asthma education).

Outpatient referrals are accepted from both general practitioners as well as other medical specialists (eg: general and sub specialist paediatricians, paediatric surgeons).

Respiratory Team

Senior medical specialists

Dr Rifat Chaudry
Dr Tanya Gulliver
Professor Joerg Mattes (Chair and Head of Paediatrics and Child Health - UoN)
Dr Geshani Jayasuriya

Clinical nurse consultants

Ms Linda Cheese
Ms Bernadette Goddard

In addition there are rotating junior medical staff (a registrar and senior resident medical officer) and specialist allied health professionals including dietitians, physiotherapists and social workers who support the service.

Paediatric Respiratory

The specialist respiratory service is provided by a multidisciplinary team comprising of medical, nursing and allied health professionals. The service is supported by pathology, imaging (including interventional radiology) and related disciplines. The range of conditions managed by the service is broad and includes:

• Asthma (including asthma education)
• Chronic lung disease of infancy
• Congenital pulmonary and airway lesions
• Complex respiratory infections
• Bronchiectasis
• Interstitial and restrictive lung diseases
• Cleft palate
• Respiratory complications of neuromuscular disorders

Sleep Unit and Oxygen and Ventilatory Support service

The fully Thoracic Society of Australia and New Zealand (TSANZ) accredited Paediatric Sleep Unit provides a diagnostic and treatment service for patients with disorders in sleep including:

• Obstructive sleep apnoea and other sleep disordered breathing
• Cleft palate
• Narcolepsy and related conditions
• Neurological conditions affecting sleep.

Sleep investigations include oximetry and polysomnography (PSG), provided within a four bedded sleep laboratory. Up to 16 sleep studies can be performed per week as well as other specialised testing including multiple sleep latency testing (MSLT).

This service also provides a home oxygen and ventilatory (including CPAP and Non Invasive Ventilation) support service for patients with chronic lung, airway, and sleep disorders. Two dedicated Non-Invasive Ventilation clinics are held each year.

Cystic fibrosis

A weekly outpatient clinic is provided for patients with cystic fibrosis. The clinic is multidisciplinary and incorporates respiratory specialists, clinical nurse consultants, physiotherapists and dietitians. In addition a social/community worker and a home based airway clearance service, funded by Cystic Fibrosis New South Wales.

Infants identified by Newborn Screening with Cystic Fibrosis or as carriers of this condition are referred for sweat testing and further management including genetic counselling and extended family screening.

Close association exists with Hunter Genetic services, with a genetic counsellor attending on a monthly basis. Counselling services are also available at other times (time of diagnosis). The clinic also has an established home physiotherapy service. The clinic also liaises with CF NSW Community Worker and Homecare to assist with airway clearance techniques at home.

For information on COVID-19, please download our message to CF families.

Lung function laboratory

There is a dedicated paediatric respiratory function laboratory, which is managed by the respiratory service. Testing available within the laboratory includes:

• Spirometry (with bronchodilator response testing)
• Bronchial provocation testing (hypertonic saline challenge)
• Static lung volumes (whole body plethysmography)
• Altitude simulation testing
• Allergy skin prick testing
• Infant lung function testing (research only)

As well as internal referrals from John Hunter Children's Hospital, external referrals can be made directly to the laboratory by general practitioners and specialists.

Bronchoscopy

The unit provides a full flexible bronchoscopy service to the hospital and region. The JHCH facilitates this with a dedicated operating time (one session per fortnight) and flexible bronchoscopes with video imaging ranging in size from 2.7 mm to 4.9 mm. There is a full-time paediatric anaesthetic service available to facilitate both elective and emergency bronchoscopic procedures.

A close relationship exists with the Paediatric Ear, Nose and Throat Surgical Team and combined investigation with rigid bronchoscopes is facilitated.

How do you make an appointment?

All referrals must be written by a medical practitioner.

Referral criteria:

• Age 0-16 years
• General practitioner and specialist referrals accepted
• Specific respiratory conditions such as asthma, airway abnormality, chronic cough, etc.
• Sleep disorders such as obstructive sleep apnoea, etc.

Referrals for generalised allergic disorders and non respiratory specific general paediatric conditions, including behavioural disorders will not be accepted.

All external referrals for specialist respiratory and sleep appointments are to be in hard copy form with full patient details including contact mobile phone number, Use SeNT eReferral to send referrals to HNELHD.  If your GP management system does not support SeNT, you may FAX referral to:

Paediatric outpatient appointments
Fax:  (02)49 223904

Paediatric outpatient appointment enquiries
Phone:  (02)49 213750

External referrals to the Respiratory Function Laboratory can be made directly by:
Fax (02)49 213680 or phone: (02)49 213679.

For urgent referrals please contact the on duty respiratory specialist via hospital switchboard on (02)49 213000.

Contact details

Paediatric Respiratory Unit
John Hunter Children's Hospital
Address:   John Hunter Children's Hospital, Lookout Road, New Lambton Heights. NSW 2305
Postal:    Locked Bag 1, Hunter Region Mail Centre. NSW 2310

Paediatric Sleep Unit
John Hunter Children's Hospital
Address: John Hunter Children's Hospital, Lookout Road, New Lambton Heights. NSW 2305
Postal: Locked Bag 1, Hunter Region Mail Centre. NSW 2310

Paediatric Respiratory Function Laboratory
John Hunter Children's Hospital
Address:   John Hunter Children's Hospital, Lookout Road, New Lambton Heights. NSW 2305
Postal: Locked Bag 1, Hunter Region Mail Centre. NSW 2310

For emergencies please contact the on duty respiratory specialist via John Hunter switch on (02)49 213000.