Children Respiratory Unit

Children’s Respiratory Care Department Background In 2004, the Herzog Hospital undertook to establish a Children’s Respiratory Unit. This was based on our experience and success in treating older patients with chronic respiratory problems, including supporting them for extended periods of time on respirators and weaning them from breathing support. Children represent a unique challenge in this very specialized field. Congenital defects, genetic diseases or trauma caused by accidents or malice (such as a falls, drowning, car accidents terror attacks etc’) cause such severe injuries that the child requires the continued support of a respirator to breathe. In February 2005, thanks to the generosity of the Kennedy Leigh Charitable Trust and other donors, the hospital opened the Unit and admitted the first children requiring respiratory assistance. The special circumstances of these children require that the staff in the Unit work not only to care for each child as an individual, but also to provide support to their parents and families. As such, they derive great satisfaction from their work, despite the great difficulty, developing close relationships with the patients and their families. The Need for Expansion Since its establishment, the demand for the Children's Unit has exceeded its capacity by far. Starting with 4 beds, the Unit rapidly expanded to a nominal capacity of 14 beds. Yet in the last year alone there have regularly been 16-20 children, aged between 3 months and 18 years, hospitalized in the Unit. The need is growing rapidly as a result of medical technology’s rapid advance, enabling doctors to salvage victims of accidents and disease where previously there was no help. Routinely there are a number of children awaiting a bed in the Unit. Yet, because of lack of room and services, they cannot be admitted and have to remain in the general hospitals, denied proper care. Recently another room was added – at the expense of the adjacent adult unit – which added an additional 6 beds, raising the nominal capacity to 20 beds (with between 20-24 children squeezed into the unit at any given time). Based on the current waiting list it is clear that we already need many more than 24 beds for all ages and within a couple of years shall probably require more or less double the number of beds. There is no room for further beds in the Jerusalem area in the near future except for the beds planned here in the Herzog Hospital. Plans for the construction of a new Department So as to answer the projected needs, the hospital plans to construct a new wing dedicated to children’s respiratory care, which will occupy its own floor in the new medical Pavilion which is currently under construction. It will offer much needed space and facilities for the growing number of children that require the specialized care of the Herzog Hospital staff. The planned Children’s Respiratory Wing is designed as a centralized area dedicated to the treatment of children dependent on respirators and other technology. The Children’s Respiratory Care Wing will be comprised of:  Two departments of 28 beds each, with option to expand as need arises.  Each Department built around a central core, which will house the nurses’ station, treatment facilities and preparation area.  Around the central core special beds shall be arranged as to permit direct observation of each bed from the nursing station as an intensive care.  The beds shall separated by transparent partitions which will reduce cross infection but will not obstruct the direct view of each bed. Some of the intensive care beds shall be equipped with hemodialysis facilities.  The Departments will be divided by age and weight of the children. There will be complete flexibility to enable variations according to the actual need at any given time.  Additional departmental facilities will include: 1. Physiotherapy and occupational therapy – a room for a physiotherapist and occupational therapist will be part of the department. This will enable children, to receive therapy close to their beds without having to transport them. 2. “Snoezlen”/Recreational Room – a multi-sensory stimulating environment used to stimulate the senses of the patient. Even in a state of reduced consciousness the sensory faculties of the child are often still functioning. By stimulating them there is a greater chance of reviving dormant functions in the brain and keeping it active. We have observed marked changes in children, otherwise unconscious, when treated by multi-sensory stimulation. 3. General offices such as rooms for the doctors, staff meetings, the head nurse, social workers etc. 4. A dining room for those children who are able to eat sitting up and to socialize at the same time. 5. Family room – will act as a meeting place for families as well as to enable those children, who can do so, to visit with them in a quiet environment as well as watch television and socialize. The Patients Patients in the unit come from all over the country – from as far away as the Negev and the Galil and from backgrounds as varied as Bedouin tribes and Arab families from the West Bank area to Ultra-orthodox families from the Mea Shearim. Of the 33 children treated in the unit to date, 11 were Arab (Moslem/Christian) and the rest Jewish. 6 were discharged home or to rehabilitation centres and 7 passed away. The average stay has been over 18 months (with most of the children in the unit since the day they arrived). The children admitted into the department fall into three basic categories: 1. Congenital Defects: Consanguineous marriages in Israel are not unusual, especially amongst the Moslems and Ultra-Orthodox Jews. This increases the risk of genetic and other congenital defects. Some of the defects are found during pregnancy by ultrasound but for various reasons the pregnancy is not terminated. Others are not detected. Such children often suffer from breathing difficulties and also suffer from severe congenital deformations and disabilities. Even after they grow sufficiently to maintain body heat outside an incubator, they sometimes need artificial respiration to live. 2. Acquired diseases: These begin at a much later stage. Some are relatively rare diseases with an unknown aetiology, others are clear cut. Some are self limiting whilst others are progressive and destructive. The process usually comes as a complete shock and is unexpected by the parents. 3. Traumatic Events: These can be accidents, such as traffic or sports injuries. Others are a result of malice such as terror attacks, child abuse and other such problems. Here there are complicated social circumstances involved which put a severe strain on the staff and especially the social worker. The following are stories of four typical cases involving children hospitalized at Herzog Hospital's Child Respiratory Unit: Child A was hospitalized at Herzog just over three years ago and was the first child to be admitted to the then new Unit. Having been born with a genetic defect, which rendered her learning disabled and blind, she was in constant need of nursing care. Following a case of severe pneumonia at the age of 16, her health deteriorated and she required respiratory care, first at Hadassah Hospital and then at Alyn Hospital. Finally, when it became clear that her health would not improve, she was transferred to Herzog Hospital as the only place in the Jerusalem area that could provide the care that was required on a long-term basis. Today the family have seen the professional and devoted care provided by Herzog’s staff. Their daughter, who now recognizes her family and team of nurses via their voices, is in a semi-conscious state. Child B was admitted to Herzog Hospital at the age of 15. Also having been born with a genetic defect, her health began to deteriorate within the last year. She was hospitalized at Sha’are Zedek Medical Center with severe neurological deterioration and in need of respiratory care. When she first arrived at Herzog she was completely paralyzed, unconscious and had a pressure sore. Her condition has since improved and she has begun to respond to her surroundings. Through the expert care and attention given by Herzog’s Pressure Sore Unit, the girl’s pressure sores have healed completely. Child C is a 4 year old child. He was initially admitted to the intensive care Unit of Hadassah with unexplained injuries which included brain haemorrhages, brain damage, burns and other injuries which did not make coherent sense. After a police investigation it transpired that the child was a victim of very serious child abuse. Severely brain damaged and unconscious, the child was stabilized in the intensive care Unit and then transferred to our Unit for continuing care. He is currently still unconscious although showing some minor response and still requires a respirator to keep him alive. He is one of the most serious and extreme cases of child abuse seen in recent years in the country and the case is still under police investigation. This particular case requires a very dedicated and devoted team to care for him as well as deal with the media exposure and the family members. Child D was admitted in May 2005. She is a little girl who was hospitalized in critical condition after a tragic accident at home. She was resuscitated but her brain was deprived of oxygen for long enough to cause irreversible brain damage. After hospitalization at Hadassah, she arrived at our Unit in the Herzog Hospital. She had pressure sores which we successfully treated, as well as a severe eye abscess. Although the girl is unconscious, her family often comes to talk to her, play music and sing. The family raised a donation in order to buy a special wheelchair for their daughter, costing more than $2,000, which enables them to take her through the Hospital’s gardens. They recently celebrated her fifth birthday at the hospital. Some time ago the staff took the girl for the first time to the multi-sensory Snoezlen Room where she was exposed to various elements that stimulate the senses of vision, hearing, touch, taste and smell. The girl seemed more relaxed in the Snoezlen Room and had some physical responses. The staff now take her there once a week. The Equipment A “bed” is the term used for the location of one patient. Each such location has to be equipped with both fixed infrastructure, which is “hard wired” into the floors, walls and ceilings and with mobile, interchangeable equipment which is tailored to each child according to his needs. Due to the nature of the patients the infrastructure is very specialized. It includes such items as piped oxygen, piped air, vacuum sources, special dual electrical systems (called “floating systems” which isolate the patient supply from the main electrical supply), backup systems for emergencies, various water and other drainage systems, patient/nurse intercoms, alarm systems, computerized closed circuit TV (to monitor the patients) and many other systems. The mobile equipment includes respirators, monitors for the life support parameters, the beds themselves (including specially designed beds for babies), special mattresses, feeding pumps, infusion pumps and so on. In addition there are items which are common to a number of patients or rooms, equipment for the nurses’ station, physiotherapy and occupational therapy rooms and many other functions of the department. See Appendix B for a partial list of mobile equipment costs (not included in the estimate for the construction costs in this proposal). The Budget Due to the infrastructure required for this type of care, the building costs for a wing of this type are high. The total floor area of the wing, comprising both departments and the common office area will be about 2900 square meters and the estimated cost will be about US$6,500,000-6,800,000 (depending on the rate of exchange of the dollar and the cost of materials at the actual time of construction). Financial Support Herzog Hospital is an NPO/NGO which receives no government funding of any sort, yet it is one of the very few hospitals in Israel that maintains a balanced budget. For all that, we are in need of support for capital expenditure, and special programs to meet growing needs, as the income form the running of the hospital is unable to support these costs in addition to the actual running costs. The philosophy of care in the planned department is at the forefront of children’s respiratory care in the world today. The nature of this department is unique and only one other department of its type exists in Israel and is quite rare in the world altogether. The new Children’s Respiratory Care Department will create an optimal physical and emotional environment for the benefit of our young patients and their families. Partial Equipment List for Children’s Respiratory Dept Cost is per Unit in US Dollars (including shipping, insurance and parts and maintenance). Figures are in US Dollars including shipping, insurance and maintenance.   MOBILE X-RAY UNIT– ONE required Used to take X-rays of patients in the departments. $35,000     RESPIRATORS FOR ADULTS – TWENTY FIVE required Used to support patients who are unable to breath on their own. $20,000     RESPIRATORS FOR CHILDREN– TEN required Used to support children who are unable to breath on their own. $20,000     MOBILE SNOEZLEN ROOM – ONE required Multi-stimulating environment can be brought to the patient’s bedside. $17,000     BLADDER SCANNER – ONE required Non-invasive equipment to determine bladder volume, to reduce unnecessary catheterization and the possible risk of infection. $15,000     FULLY EQUIPPED CRASH CART– FOUR required With all acute care emergency equipment, including defibrillator and pulse oximeter. To rush emergency aid in critical care situations. $12,000     FULLY EQUIPPED PEDIATRIC CRASH CART With all acute care emergency equipment, including defibrillator and pulse oximeter. To rush emergency aid in critical care situations. $12,000     HEART MONITORS – FOUR required Attached to the critical care patient, this machine keeps moment-to-moment track of all essential heart functions and alerts doctors and nurses to any sudden change in vital heart functioning, especially during weaning from respirators. $10,000     DEFIBRILLATORS – THREE required Electric-shock, life-saving apparatus for victims of heart attacks. Used for patients in intensive care. $9,000     COMMERCIAL FOOD GRINDER/BLENDER – ONE required For preparing food for patients unable to swallow. $6,000     CUSTOM DESIGNED CHILDREN’S BEDS WITH SPECIAL MATTRESS For the children in the Children’s Chronic Respiratory Unit. $5,000     STATE-OF-THE-ART BEDS – THIRTY required For rehabilitation and acute care patients, with attachments for respirator apparatus, oxygenators and other vital life-saving devices. $5,000     STANDARD ELECTRO-CARDIOGRAPHS (ECG) – FOUR required A regular “workhorse” for day-to-day use in heart examination. $5,000     HI-LO TABLES– FOUR required May be electrically adjusted to accommodate patients either in wheelchairs or while standing. $4,000     SPECIAL NEED WHEELCHAIRS FOR CHILDREN For handicapped children with special needs $4,000     FOOD BLENDER– ONE required Sorely needed by our kitchen, which prepares over 2,000 meals daily. $3,500     MOBILE VITAL SIGNS MONITOR– SIX required Measures blood pressure (non-invasive), oxygen saturation, pulse rate and body temperature. Used for very ill patients who are not in an intensive care bed. $3,000     SPECIAL NEED WHEELCHAIR– TWENTY required For handicapped patients with special needs – e.g. patients with a missing limb. $2,500     COMPUTERS FOR MULTI-MEDIA TRAINING– FOUR required Used in lectures to residents and medical students. $2,300     COMPUTERS – TEN required Various departments need to upgrade outdated computers $2,000     FOOD CARTS – TEN required To deliver properly heated food to all departments $2,000     SPECIAL SHOWER BEDS Enables a patient to be showered while lying down – especially for bed-ridden patients. $1700     PULSE OXIMETERS – TWENTY required Important diagnostic device for patients with breathing and circulatory problems. It measures the amount of oxygen in the blood. $1,500     STANDARD WHEELCHAIRS – ONE-HUNDRED required Modern, standard folding wheelchair for handicapped patients. $1,500     SPECIAL MATTRESSES– SIXTY required Used for acute care and other patients requiring special care who are at high risk of developing pressure sores. $1,200     AMPLIFIER SYSTEM– ONE required For use in the lecture hall for medical seminars, administrative meetings, etc. $1,200     AUTOMATED PATIENT FEEDER – TWENTY required Feeds patients unable to eat naturally. Supplies nourishment on a controlled basis. Its computer immediately alerts nurse of any malfunction or change in patient’s ability to intake nourishment. $1,000     IVAC - INFUSION PUMPS – TEN required To supply medication intravenously, continuously in a controlled fashion. $1,000     SPECIAL SLINGS – THREE required To support arms or legs in various positions during treatment. $1,000     SPECIAL SHOWER BEDS – THREE required Enables a patient to be showered while lying down – especially for bed-ridden patients. $800     BLOOD CART– ONE required With equipment for the taking samples of blood. $675     MEDICAL EQUIPEMENT CART– ONE required Portable medical equipment cabinet, to support basic and essential medical treatment. $675     The Hospital has many endowment opportunities to provide health care for the indigent; advanced studies for nurses; residency training and for research. Herzog Hospital maintains various deferred giving opportunities. Our financial advisors are available throughout the world to help you with your financial planning, including wills and bequests. The Hospital is authorized to issue receipts valid for income tax purposes in the USA, Israel, Canada, UK, Holland, Germany and France. We also accept the donation of Israel Bonds and stocks.     FOR FURTHER INFORMATION PLEASE CONTACT SARAH HERZOG HOSPITAL Department of Development Givat Shaul Street P.O. Box 3900 Jerusalem 91351 Israel Tel: 972-2-531-6875 Fax: 972-2-652-1881 e-mail: info@herzoghospital.org> American Friends of  Herzog Hospital 15 East 32tndStreet, 8 Floor New York, NY 10016 USA Tel: 212-683-3702 Fax: 212-683-3722 e-mail: saraherzog@aol.com>   British Friends of Herzog Hospital Woodlea, 37 The Avenue Radlett, WD7 7DQ ENGLAND Tel/Fax: 44-(0)1923-850-050 e-mail: info@herzoghospital.co.uk> Canadian Friends of  Herzog Hospital 3101 Bathurst Street, #606 Toronto, ON M6A 2A6 Canada Tel: 416-256-4222 Fax: 416-256-1446 e-mail: herzoghosp@rogers.com>   Asociacion Latinoamericana de Amigos del Hospital Herzog, Jerusalem Consist Mexico S.A.de C.V. Blvd. Avila Camacho 88, Piso 10 Col. Lomas de Chapultepec Mexico City,  DF   11000 Tel: 52-55-5201-3666 Fax: 52-55-52013635 e-mail: imagen@012.net.il>

Children Respiratory Unit

Children’s Respiratory Care Department Background In 2004, the Herzog Hospital undertook to establish a Children’s Respiratory Unit. This was based on our experience and success in treating older patients with chronic respiratory problems, including supporting them for extended periods of time on respirators and weaning them from breathing support. Children represent a unique challenge in this very specialized field. Congenital defects, genetic diseases or trauma caused by accidents or malice (such as a falls, drowning, car accidents terror attacks etc’) cause such severe injuries that the child requires the continued support of a respirator to breathe. In February 2005, thanks to the generosity of the Kennedy Leigh Charitable Trust and other donors, the hospital opened the Unit and admitted the first children requiring respiratory assistance. The special circumstances of these children require that the staff in the Unit work not only to care for each child as an individual, but also to provide support to their parents and families. As such, they derive great satisfaction from their work, despite the great difficulty, developing close relationships with the patients and their families. The Need for Expansion Since its establishment, the demand for the Children's Unit has exceeded its capacity by far. Starting with 4 beds, the Unit rapidly expanded to a nominal capacity of 14 beds. Yet in the last year alone there have regularly been 16-20 children, aged between 3 months and 18 years, hospitalized in the Unit. The need is growing rapidly as a result of medical technology’s rapid advance, enabling doctors to salvage victims of accidents and disease where previously there was no help. Routinely there are a number of children awaiting a bed in the Unit. Yet, because of lack of room and services, they cannot be admitted and have to remain in the general hospitals, denied proper care. Recently another room was added – at the expense of the adjacent adult unit – which added an additional 6 beds, raising the nominal capacity to 20 beds (with between 20-24 children squeezed into the unit at any given time). Based on the current waiting list it is clear that we already need many more than 24 beds for all ages and within a couple of years shall probably require more or less double the number of beds. There is no room for further beds in the Jerusalem area in the near future except for the beds planned here in the Herzog Hospital. Plans for the construction of a new Department So as to answer the projected needs, the hospital plans to construct a new wing dedicated to children’s respiratory care, which will occupy its own floor in the new medical Pavilion which is currently under construction. It will offer much needed space and facilities for the growing number of children that require the specialized care of the Herzog Hospital staff. The planned Children’s Respiratory Wing is designed as a centralized area dedicated to the treatment of children dependent on respirators and other technology. The Children’s Respiratory Care Wing will be comprised of:  Two departments of 28 beds each, with option to expand as need arises.  Each Department built around a central core, which will house the nurses’ station, treatment facilities and preparation area.  Around the central core special beds shall be arranged as to permit direct observation of each bed from the nursing station as an intensive care.  The beds shall separated by transparent partitions which will reduce cross infection but will not obstruct the direct view of each bed. Some of the intensive care beds shall be equipped with hemodialysis facilities.  The Departments will be divided by age and weight of the children. There will be complete flexibility to enable variations according to the actual need at any given time.  Additional departmental facilities will include: 1. Physiotherapy and occupational therapy – a room for a physiotherapist and occupational therapist will be part of the department. This will enable children, to receive therapy close to their beds without having to transport them. 2. “Snoezlen”/Recreational Room – a multi-sensory stimulating environment used to stimulate the senses of the patient. Even in a state of reduced consciousness the sensory faculties of the child are often still functioning. By stimulating them there is a greater chance of reviving dormant functions in the brain and keeping it active. We have observed marked changes in children, otherwise unconscious, when treated by multi-sensory stimulation. 3. General offices such as rooms for the doctors, staff meetings, the head nurse, social workers etc. 4. A dining room for those children who are able to eat sitting up and to socialize at the same time. 5. Family room – will act as a meeting place for families as well as to enable those children, who can do so, to visit with them in a quiet environment as well as watch television and socialize. The Patients Patients in the unit come from all over the country – from as far away as the Negev and the Galil and from backgrounds as varied as Bedouin tribes and Arab families from the West Bank area to Ultra-orthodox families from the Mea Shearim. Of the 33 children treated in the unit to date, 11 were Arab (Moslem/Christian) and the rest Jewish. 6 were discharged home or to rehabilitation centres and 7 passed away. The average stay has been over 18 months (with most of the children in the unit since the day they arrived). The children admitted into the department fall into three basic categories: 1. Congenital Defects: Consanguineous marriages in Israel are not unusual, especially amongst the Moslems and Ultra-Orthodox Jews. This increases the risk of genetic and other congenital defects. Some of the defects are found during pregnancy by ultrasound but for various reasons the pregnancy is not terminated. Others are not detected. Such children often suffer from breathing difficulties and also suffer from severe congenital deformations and disabilities. Even after they grow sufficiently to maintain body heat outside an incubator, they sometimes need artificial respiration to live. 2. Acquired diseases: These begin at a much later stage. Some are relatively rare diseases with an unknown aetiology, others are clear cut. Some are self limiting whilst others are progressive and destructive. The process usually comes as a complete shock and is unexpected by the parents. 3. Traumatic Events: These can be accidents, such as traffic or sports injuries. Others are a result of malice such as terror attacks, child abuse and other such problems. Here there are complicated social circumstances involved which put a severe strain on the staff and especially the social worker. The following are stories of four typical cases involving children hospitalized at Herzog Hospital's Child Respiratory Unit: Child A was hospitalized at Herzog just over three years ago and was the first child to be admitted to the then new Unit. Having been born with a genetic defect, which rendered her learning disabled and blind, she was in constant need of nursing care. Following a case of severe pneumonia at the age of 16, her health deteriorated and she required respiratory care, first at Hadassah Hospital and then at Alyn Hospital. Finally, when it became clear that her health would not improve, she was transferred to Herzog Hospital as the only place in the Jerusalem area that could provide the care that was required on a long-term basis. Today the family have seen the professional and devoted care provided by Herzog’s staff. Their daughter, who now recognizes her family and team of nurses via their voices, is in a semi-conscious state. Child B was admitted to Herzog Hospital at the age of 15. Also having been born with a genetic defect, her health began to deteriorate within the last year. She was hospitalized at Sha’are Zedek Medical Center with severe neurological deterioration and in need of respiratory care. When she first arrived at Herzog she was completely paralyzed, unconscious and had a pressure sore. Her condition has since improved and she has begun to respond to her surroundings. Through the expert care and attention given by Herzog’s Pressure Sore Unit, the girl’s pressure sores have healed completely. Child C is a 4 year old child. He was initially admitted to the intensive care Unit of Hadassah with unexplained injuries which included brain haemorrhages, brain damage, burns and other injuries which did not make coherent sense. After a police investigation it transpired that the child was a victim of very serious child abuse. Severely brain damaged and unconscious, the child was stabilized in the intensive care Unit and then transferred to our Unit for continuing care. He is currently still unconscious although showing some minor response and still requires a respirator to keep him alive. He is one of the most serious and extreme cases of child abuse seen in recent years in the country and the case is still under police investigation. This particular case requires a very dedicated and devoted team to care for him as well as deal with the media exposure and the family members. Child D was admitted in May 2005. She is a little girl who was hospitalized in critical condition after a tragic accident at home. She was resuscitated but her brain was deprived of oxygen for long enough to cause irreversible brain damage. After hospitalization at Hadassah, she arrived at our Unit in the Herzog Hospital. She had pressure sores which we successfully treated, as well as a severe eye abscess. Although the girl is unconscious, her family often comes to talk to her, play music and sing. The family raised a donation in order to buy a special wheelchair for their daughter, costing more than $2,000, which enables them to take her through the Hospital’s gardens. They recently celebrated her fifth birthday at the hospital. Some time ago the staff took the girl for the first time to the multi-sensory Snoezlen Room where she was exposed to various elements that stimulate the senses of vision, hearing, touch, taste and smell. The girl seemed more relaxed in the Snoezlen Room and had some physical responses. The staff now take her there once a week. The Equipment A “bed” is the term used for the location of one patient. Each such location has to be equipped with both fixed infrastructure, which is “hard wired” into the floors, walls and ceilings and with mobile, interchangeable equipment which is tailored to each child according to his needs. Due to the nature of the patients the infrastructure is very specialized. It includes such items as piped oxygen, piped air, vacuum sources, special dual electrical systems (called “floating systems” which isolate the patient supply from the main electrical supply), backup systems for emergencies, various water and other drainage systems, patient/nurse intercoms, alarm systems, computerized closed circuit TV (to monitor the patients) and many other systems. The mobile equipment includes respirators, monitors for the life support parameters, the beds themselves (including specially designed beds for babies), special mattresses, feeding pumps, infusion pumps and so on. In addition there are items which are common to a number of patients or rooms, equipment for the nurses’ station, physiotherapy and occupational therapy rooms and many other functions of the department. See Appendix B for a partial list of mobile equipment costs (not included in the estimate for the construction costs in this proposal). The Budget Due to the infrastructure required for this type of care, the building costs for a wing of this type are high. The total floor area of the wing, comprising both departments and the common office area will be about 2900 square meters and the estimated cost will be about US$6,500,000-6,800,000 (depending on the rate of exchange of the dollar and the cost of materials at the actual time of construction). Financial Support Herzog Hospital is an NPO/NGO which receives no government funding of any sort, yet it is one of the very few hospitals in Israel that maintains a balanced budget. For all that, we are in need of support for capital expenditure, and special programs to meet growing needs, as the income form the running of the hospital is unable to support these costs in addition to the actual running costs. The philosophy of care in the planned department is at the forefront of children’s respiratory care in the world today. The nature of this department is unique and only one other department of its type exists in Israel and is quite rare in the world altogether. The new Children’s Respiratory Care Department will create an optimal physical and emotional environment for the benefit of our young patients and their families. Partial Equipment List for Children’s Respiratory Dept Cost is per Unit in US Dollars (including shipping, insurance and parts and maintenance). Figures are in US Dollars including shipping, insurance and maintenance.   MOBILE X-RAY UNIT– ONE required Used to take X-rays of patients in the departments. $35,000     RESPIRATORS FOR ADULTS – TWENTY FIVE required Used to support patients who are unable to breath on their own. $20,000     RESPIRATORS FOR CHILDREN– TEN required Used to support children who are unable to breath on their own. $20,000     MOBILE SNOEZLEN ROOM – ONE required Multi-stimulating environment can be brought to the patient’s bedside. $17,000     BLADDER SCANNER – ONE required Non-invasive equipment to determine bladder volume, to reduce unnecessary catheterization and the possible risk of infection. $15,000     FULLY EQUIPPED CRASH CART– FOUR required With all acute care emergency equipment, including defibrillator and pulse oximeter. To rush emergency aid in critical care situations. $12,000     FULLY EQUIPPED PEDIATRIC CRASH CART With all acute care emergency equipment, including defibrillator and pulse oximeter. To rush emergency aid in critical care situations. $12,000     HEART MONITORS – FOUR required Attached to the critical care patient, this machine keeps moment-to-moment track of all essential heart functions and alerts doctors and nurses to any sudden change in vital heart functioning, especially during weaning from respirators. $10,000     DEFIBRILLATORS – THREE required Electric-shock, life-saving apparatus for victims of heart attacks. Used for patients in intensive care. $9,000     COMMERCIAL FOOD GRINDER/BLENDER – ONE required For preparing food for patients unable to swallow. $6,000     CUSTOM DESIGNED CHILDREN’S BEDS WITH SPECIAL MATTRESS For the children in the Children’s Chronic Respiratory Unit. $5,000     STATE-OF-THE-ART BEDS – THIRTY required For rehabilitation and acute care patients, with attachments for respirator apparatus, oxygenators and other vital life-saving devices. $5,000     STANDARD ELECTRO-CARDIOGRAPHS (ECG) – FOUR required A regular “workhorse” for day-to-day use in heart examination. $5,000     HI-LO TABLES– FOUR required May be electrically adjusted to accommodate patients either in wheelchairs or while standing. $4,000     SPECIAL NEED WHEELCHAIRS FOR CHILDREN For handicapped children with special needs $4,000     FOOD BLENDER– ONE required Sorely needed by our kitchen, which prepares over 2,000 meals daily. $3,500     MOBILE VITAL SIGNS MONITOR– SIX required Measures blood pressure (non-invasive), oxygen saturation, pulse rate and body temperature. Used for very ill patients who are not in an intensive care bed. $3,000     SPECIAL NEED WHEELCHAIR– TWENTY required For handicapped patients with special needs – e.g. patients with a missing limb. $2,500     COMPUTERS FOR MULTI-MEDIA TRAINING– FOUR required Used in lectures to residents and medical students. $2,300     COMPUTERS – TEN required Various departments need to upgrade outdated computers $2,000     FOOD CARTS – TEN required To deliver properly heated food to all departments $2,000     SPECIAL SHOWER BEDS Enables a patient to be showered while lying down – especially for bed-ridden patients. $1700     PULSE OXIMETERS – TWENTY required Important diagnostic device for patients with breathing and circulatory problems. It measures the amount of oxygen in the blood. $1,500     STANDARD WHEELCHAIRS – ONE-HUNDRED required Modern, standard folding wheelchair for handicapped patients. $1,500     SPECIAL MATTRESSES– SIXTY required Used for acute care and other patients requiring special care who are at high risk of developing pressure sores. $1,200     AMPLIFIER SYSTEM– ONE required For use in the lecture hall for medical seminars, administrative meetings, etc. $1,200     AUTOMATED PATIENT FEEDER – TWENTY required Feeds patients unable to eat naturally. Supplies nourishment on a controlled basis. Its computer immediately alerts nurse of any malfunction or change in patient’s ability to intake nourishment. $1,000     IVAC - INFUSION PUMPS – TEN required To supply medication intravenously, continuously in a controlled fashion. $1,000     SPECIAL SLINGS – THREE required To support arms or legs in various positions during treatment. $1,000     SPECIAL SHOWER BEDS – THREE required Enables a patient to be showered while lying down – especially for bed-ridden patients. $800     BLOOD CART– ONE required With equipment for the taking samples of blood. $675     MEDICAL EQUIPEMENT CART– ONE required Portable medical equipment cabinet, to support basic and essential medical treatment. $675     The Hospital has many endowment opportunities to provide health care for the indigent; advanced studies for nurses; residency training and for research. Herzog Hospital maintains various deferred giving opportunities. Our financial advisors are available throughout the world to help you with your financial planning, including wills and bequests. The Hospital is authorized to issue receipts valid for income tax purposes in the USA, Israel, Canada, UK, Holland, Germany and France. We also accept the donation of Israel Bonds and stocks.     FOR FURTHER INFORMATION PLEASE CONTACT SARAH HERZOG HOSPITAL Department of Development Givat Shaul Street P.O. Box 3900 Jerusalem 91351 Israel Tel: 972-2-531-6875 Fax: 972-2-652-1881 e-mail: info@herzoghospital.org> American Friends of  Herzog Hospital 15 East 32tndStreet, 8 Floor New York, NY 10016 USA Tel: 212-683-3702 Fax: 212-683-3722 e-mail: saraherzog@aol.com>   British Friends of Herzog Hospital Woodlea, 37 The Avenue Radlett, WD7 7DQ ENGLAND Tel/Fax: 44-(0)1923-850-050 e-mail: info@herzoghospital.co.uk> Canadian Friends of  Herzog Hospital 3101 Bathurst Street, #606 Toronto, ON M6A 2A6 Canada Tel: 416-256-4222 Fax: 416-256-1446 e-mail: herzoghosp@rogers.com>   Asociacion Latinoamericana de Amigos del Hospital Herzog, Jerusalem Consist Mexico S.A.de C.V. Blvd. Avila Camacho 88, Piso 10 Col. Lomas de Chapultepec Mexico City,  DF   11000 Tel: 52-55-5201-3666 Fax: 52-55-52013635 e-mail: imagen@012.net.il>