CALL-Me icon


  • Author:

    FussyLogic Ltd

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The description of CALL-Me

Until recently, the onset of diaphragmatic weakness in amyotrophic lateral sclerosis (ALS) had no effective treatment other than palliation by opiates and similar drugs. The use of respiratory support through non-invasive ventilation is now widespread, allowing relief from symptoms related to type 2 respiratory failure such as severe breathlessness, loss of appetite, headache and excessive daytime sleepiness. A consequence of type 2 neuromuscular respiratory failure is elevation of blood carbon dioxide levels that are tolerated by adaptation of physiologic control systems. Since
elevation of blood carbon dioxide is the usual trigger for respiration, tolerance means an alternative trigger is used, that of a low blood oxygen. The treatment of someone with chronic type 2 respiratory failure with oxygen therefore negates the only remaining trigger for breathing and results in drowsiness followed by death.

A common treatment response by emergency services to anyone in extremis, and especially those with breathlessness, is the use of high dose oxygen delivered by mask. Individuals with ALS in type 2 respiratory failure may suffer reversible complications such as pneumonia, and be inappropriately prescribed high dose oxygen by emergency services. Alternatively, they may be in the end stages of ALS, when an emergency room is not a desirable or appropriate location for end-of-life care, and a better response would be use of community
palliative care services.

A solution would be the notification of specialist ALS teams of the arrival of someone with ALS in an A&E department, to allow advice, education and intervention to be targeted, and avoidance of the morbidity and mortality associated with high dose oxygen, as well as advice regarding the appropriate treatment destination for the patient, avoiding unnecessary and distressing admission to an acute ward when inappropriate.

This app is the client-side support for a trial system to do just that. It is not, at present, intended for anyone outside of the CALL-Me system. In fact, if you install it without a pre-existing server account, you will not get anything other than a login screen.

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