Respirology Clinic

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Children, youth and families Healthcare providers

About the Respirology Clinic

The CHEO Respirology Clinic is located in clinic C9. We see children from just after birth until their 18th birthday, with complex breathing problems such as asthma, bronchopulmonary dysplasia, and recurrent pneumonias. We also see patients requiring home oxygen. The clinic is sometimes referred to as “the Chest Clinic” or “the Asthma Clinic.”

The CHEO Respirology Service is also involved in several other specialized clinics:

Children with sleep-disordered breathing or sleep apnea are seen in CHEO’s Sleep Clinic and/or Sleep Lab

Children with cystic fibrosis are seen in CHEO’s Cystic Fibrosis Clinic

Children with neuromuscular conditions such as muscular dystrophy are seen in CHEO’s Neuromuscular Clinic by a respirologist along with the rest of the Neuromuscular Team

Children with complex airway issues such as a tracheostomy are seen by the Respirologist along with the rest of the Complex Airway Team in the Complex Airway Clinic

Technology-dependent children, such as children receiving home ventilation are usually seen in the Sleep Clinic or Complex Airway Clinic, but are occasionally seen in the Respirology Clinic

Children with tracheoesophageal fistula are seen in the tracheoesophageal fistula clinic.

About our team

Our team includes six respirologists, a nurse case-manager, a certified asthma educator, respiratory therapists, and a social worker. We have access to a respiratory physiotherapist and a dietician.

A pulmonary function testing (PFT) laboratory is located in our clinic. We have ready access to the Medical Imaging (X-ray) department and the blood laboratory.

Information for children, youth and families

Before your appointment

Please sign-up for a MyChart account, prior to your first visit.

Scheduling your appointment

Our scheduling team will contact you by phone to schedule an appointment.

If something changes and you need to reschedule your appointment, please let us know at least 24-48 hours in advance if you are unable to make it by calling 613-737-7600 x2222. No-shows or frequent cancellations may result in discharge from the service.

What to bring to your appointment

If your child is on medications and/or inhaler devices (such as an Aerochamber) or other technologies (such as a BiPAP or CPAP machine, a suction machine or oxygen saturation monitor) please bring all of these with you.
If your child has had X-rays or a CT scan of the chest done in a non-hospital X-ray lab in Ontario, anywhere in Quebec, or elsewhere, please arrange to get a CD with the images (or online access to the images) to bring to the appointment. A written description of the X-ray's findings is not enough. If your child has seen specialists outside CHEO, please bring a copy of these reports with you. If your child has been hospitalized or visited emergency departments in Quebec or elsewhere outside Ontario, please bring copies of all discharge summaries or reports with you, if possible.

Arriving to your appointment

Please plan to arrive 10-15 minutes prior to your scheduled appointment time in case there are delays with parking or finding the clinic and to complete any required paperwork that may be required in advance of your visit.

We are located in Clinic C-9 on the main floor of CHEO’s main campus (401 Smyth Road).

What to expect during your appointment

In general, you should expect to be here for 60-90 minutes for a new patient appointment, and 45-60 minutes for a follow-up appointment. Given our area of practice, urgent situations may arise unexpectedly. We appreciate your patience should we need to spend extra time with a patient ahead of you.

CHEO is a teaching hospital affiliated with the University of Ottawa. As part of our commitment to the education of our future health care providers, learners of various levels and disciplines (ex. nursing students, medical students, medical residents, etc) may be involved in your care.

If your child is 6 years of age or older and can cooperate with the test, they will likely have a pulmonary function test (measuring their lungs by breathing into a computer) during the visit. If your child needs more complex testing, such as a sleep study or exercise test, these will be booked for a later date.

Patients should avoid, if possible, using the following medications before their visit to Respirology Clinic:

salbutamol (Ventolin – blue inhaler) for 4 hours prior

terbutaline (Bricanyl – white and blue inhaler) for 6 hours prior
fluticasone/salmeterol (Advair – purple inhaler) for 12 hours prior
mometasone/formoterol (Zenhale – dark blue inhaler) for 12 hours prior
budesonide/formoterol (Symbicort – red bottom inhaler) for 12 hours prior
formoterol (Oxeze – green bottom inhaler) for 12 hours prior
salmeterol (Serevent – green inhaler) for 12 hours prior
fluticasone/vilanterol (Breo – white & blue inhaler) for 12-24 hours prior
tiotropium (Spiriva – grey/turquoise inhaler) for 24 hours prior
formoterol (Oxeze – green bottom inhaler) for 12 hours prior
Ipratropium (Atrovent – white and green inhaler) for 6 hours prior

After your appointment

Your Respirologist or Nurse Practitioner will let you know whether any additional appointments or testing are required after your visit.

Frequently asked questions

How can I make an appointment?

All patients must be referred by a Physician or Nurse Practitioner. After a referral is received, we will notify the referring Physician or Nurse Practitioner whether the referral has been accepted or denied, and if accepted we will provide an estimated wait time. This wait time can vary based on demand and urgency. Once we have an appointment spot to offer, our Scheduling Team will reach out by phone to schedule an appointment.

Breathing problems are very common, and we receive a high volume of referrals. Unfortunately, this leads to a longer wait time than we would prefer. Depending on the severity of the symptoms reported in the referral, you can expect to wait 4-12 months for an initial appointment. Should symptoms worsen while you are awaiting your appointment, you can discuss with your physician who may send an update if appropriate.

Who should I contact if I am worried or have questions?

For any emergency, call 911. This includes emergencies involving your child’s respirology problem.

Our clinic has an extremely limited ability to see children on an emergency basis. If your child is either being referred for a respiratory emergency, or is already followed by the Respirology Clinic and is suddenly unwell, we recommend you bring your child to an emergency department, or, if it’s less urgent, communicate with your community physician.

For emergency situations, do not contact the Respirology Clinic by MyChart.

Recycle your used inhalers!

CHEO now has inhaler recycling bins available in front of our KidCare Pharmacy entrance, as well as in our Respirology Clinic and Emergency Department. Help us reduce medical waste and its environmental impact by dropping off your used inhalers for recycling.

Please make sure to remove any labels with names, or hide personal information with a permanent marker, before putting your inhaler in the bin!

Why is it important to recycle my inhalers?

Metered-dose inhalers (MDIs) have a pressurized propellant (hydrofluoroalkane) that is a potent greenhouse gas. Each inhaler can generate a carbon footprint equivalent to driving from Ottawa to Cornwall!

What can I do to help lower the impact of inhalers on our environment?

Continue to ensure you have the right technique when using a MDIs with the support of your care team!

Review how to know when your MDI is empty with your care team

Recycle your inhalers and related equipment in one of our dedicated recycling boxes at CHEO!

What inhaler parts can be recycled?

These inhaler parts and pieces can all be recycled in the bins:

Inhalers

Mouthpieces

Actuators

Canisters

Caps

Spacers

Valves

Packaging

Looking for more resources or supports on asthma and other respirology topics?

Asthma (including links to the Asthma e-book)

Bronchopulmonary Dysplasia

Primary Ciliary Dyskinesia (Immotile Cilia Syndrome)

Tracheoesophageal Fistula (Esophageal Atresia)

Information for healthcare providers

Looking to make a referral/request relating to sleep-disordered breathing or sleep apnea?

For consults, please refer to the Sleep and Home Ventilation Clinic.
To request a Sleep Study, visit the Sleep Lab webpage.

Children and youth must be referred by a physician or nurse practitioner. Consults should include detailed information about prior illnesses, such as:

discharge summaries
emergency department visits documentation
other consultants’ reports (particularly reports from allergists)
laboratory results
pulmonary function tests
X-rays and other imaging (if these took place outside CHEO).

If your patient has had imaging (chest X-rays, CT scans, etc.) outside of CHEO that is not available through Connecting Ontario: please provide the radiologist’s reports as part of the initial referral and have the parent/caregiver bring the actual images on a CD with them to their appointment, or provide a means for us to have online access. The radiologist’s reports alone are not sufficient.

Please let us know if an interpreter is required, and if so, what language the child, youth or family is needing interpretation in. Please provide all available contact information for the caregivers, including cell phone numbers.

Make a referral

Our clinic is now accepting e-referrals with Ocean!

If you’re already on Ocean, look us up via your account by searching "CHEO".
If you don’t yet have an Ocean account, no problem - signing up is free.

Make a referral in Ocean

You can make an e-referral using Ocean, or send a referral by mail or fax to our address below.

We have provided a number of condition-specific tips for referrals (and methods of avoiding the need for referral) below:

Referral criteria and eligibility

Referral criteria
Reason for referral	Criteria	Mandatory information to include in referral
Asthma	Children with 3 or more discrete ED visits, an admission and 2 ED visits, or an admission to PICU. We will consider accepting referrals for children with 2 or fewer ED visits if they had life-threatening exacerbations. Children must have incomplete asthma control despite a 2-3 month trial of daily moderate dose inhaled steroid to be eligible for Respirology Clinic assessment. More details here. This paper, prepared by a member of our group, also provides a brief overview of diagnosing and effectively managing asthma in children: Achieving control of asthma in preschoolers \| CMAJ To diagnose asthma in children: It is helpful to assess whether your patient has an immediate (within 15 minutes) but transient (lasting 2-6 hours) response to a short-acting bronchodilator such as salbutamol; this type of response would support a diagnosis of asthma. For suspected exercise-induced asthma, we recommend a trial of short-acting bronchodilator (such as salbutamol) 15 minutes before sporting activities. Significant improvement (or elimination) of symptoms with this intervention would support a diagnosis of exercise-induced asthma. For children 6 and over who require confirmation of asthma diagnosis, we recommend ordering a PFT rather than a Respirology consult. Note that some referrals not meeting these criteria will be redirected to partner Community Pediatricians if deemed appropriate, to facilitate timeliness of care. Other online resources that can help you manage this patient include: Ontario Health Quality Standards for Asthma in Children and Adolescents For patient/family resources on asthma, printable asthma action plans and videos on how to effectively use asthma inhalers, please here. You may wish to consider redirecting your question through Champlain BASE or OTN eConsult or refer your patient to a pediatrician in the area	If some or all ED visits or hospitalizations did not occur at CHEO, please provide dates and documentation of these encounters. Doses of asthma medications, dates and duration each medication was used Allergist’s reports (if done) CBC, IgE, previous PFT, CXR (if done, and done outside CHEO and not available on Connecting Ontario)
Chronic cough	Children must have cough occurring every day for at least 2 months to be eligible for Respirology Clinic assessment. We strongly recommend a trial of asthma therapy (see “Asthma,” above) and/or evaluation for chronic rhinosinusitis before considering referral to Respirology Clinic.	Previous trial(s) of therapy Previous laboratory testing (if done outside CHEO)
Recurrent pneumonia	Children must have at least 2 radiographically documented pneumonias at least 6 weeks apart to be eligible for Respirology Clinic assessment.	If X-rays were not done at CHEO and are not available through Connecting Ontario, please provide Radiology reports and ask your Radiology Lab to copy the images to a CD and have the patient bring the CD to the appointment.
Abnormal chest X-ray	Consider obtaining 2 X-rays at least 6 weeks apart to see if changes are persisting	If X-rays were not done at CHEO and are not available through Connecting Ontario, please provide Radiology reports and ask your Radiology Lab to copy the images to a CD and have the patient bring the CD to the appointment.
Other referrals	These will be assessed on a case-by-case basis. Children with hemoptysis will be seen on an urgent basis. For children requiring admission, please contact our Emergency Department.	Provide relevant laboratory testing (blood work, X-rays, PFT’s if not done at CHEO

Contact us

Respirology Clinic (C-9), CHEO
401 Smyth Road
Ottawa, ON K1H 8Li

Fax: 613-738-4298

For appointment scheduling, please contact CHEO’s scheduling centre: 613-737-7600 extension 2222

Our team cannot provide information to families of children or youth not already seen by a CHEO Respirologist. After your child has been seen, we encourage you to register for CHEO My Chart and contact us though there. You can reach the following members of our team through CHEO MyChart:

Respirology Clinic Nurse-Coordinator
Asthma Educator
Home Ventilation Nurse-Practitioner
Home Ventilation/Complex Lung Disease Respiratory Therapist