This collected data on over one thousand admissions of children to intensive care facilities in Trent during 1994-95. Increasing centralisation of intensive care will mean that more critically ill children are transferred between hospitals. In 1992 I undertook a prospective study of critical incidents that occurred during the transfer of children to the intensive care unit of Birmingham Children's Hospital. The study revealed a large number of potentially serious errors and ommisions that occurred during the transfers. In the autumn of 1994 I spent two months in Nepal as part of the British Mount Everest Medical Expedition, investigating respiratory defence systems and lung function at altitude.
Many climbers complain of cough and rhinorhorrea at altitude.
The cough can be debilitating, and here have been a number of documented cases of rib fractures occurring in climbers after coughing spasms. Furthermore the initiation and control of cough are poorly understood, but may be related to factors affecting the control of breathing. My main project was to study the frequency of cough, and the sensitivity of cough receptors at altitude. This involved making recordings of cough at altitudes up to 7,000 meters, and undertaking the world's highest inhalational cough challenges, at 5,300m. The results of the study demonstrated a dramatic increase in cough and cough receptor sensitivity at altitude, and an relationship between changes in cough receptor sensitivity and the hypercapnic ventilatory response, suggesting a possible link between cough and the control of breathing.