1、 AIMS OF THIS SESSIONTo nUnderstand the definitionnDiscuss causesnDiscuss diagnosisnDiscuss Management/MedicationnDiscuss Oxygen Therapy and enjoy!DEFINITIONCOPD is an umbrella term for qEmphysemaqChronic BronchitisqSevere Chronic AsthmaCHRONIC BRONCHITISDiagnosed by the production of sputum and cou
2、gh on most days for three months in two consecutive yearsEMPHYSEMA CAUSES OF COPDSMOKING:ALPHA 1 ANTITRIPSIN DEFICIENCY:GENETICOCCUPATIONAL EXPOSURE TO RESPIRATORY POLLUTANTS:DIAGNOSISnOver 35nSmoker or ex smokernno clinical features of asthmanHave any of these symptoms?exertional breathlessness chr
3、onic coughregular sputum production frequent winter“bronchitis”Wheeze (NICE 2010)SPIROMETRYCLASSIFICATION OF COPDSYMPTOMS ASSOCIATED WITH AN EXACERBATIONqDYSPNOEAnMore breathless than normalnReduced exercise tolerancenSPUTUM PRODUCTIONqIncrease in purulenceqSPUTUM VOLUMEnIncrease in normal amountqCO
4、UGH END of LIFE?Palliative care registerAdvanced directives/PPC/Assessment of concernsHospice/day hospitalRESPIRATORY FAILUREqCOR PULMONALEnPOLYCYTHAEMIAnPULMONARY EMBOLInDEPRESSION/ANXIETYRESPIRATORY FAILUREMEDICATIONSBronchodilators should be the initial treatmentAssess effectiveness bynimprovemen
5、t in symptomsnADLnexercise capacitynrapidity of relief of symptomsNote-FEV1 will not reflect any significant improvementMEDICATIONSIf symptoms persist add MEDICATIONS TREATMENT FACTORS AFFECTING CONCORDANCE OF INHALED MEDICATIONS NON TREATMENT FACTORS LONG TERM OXYGEN THERAPYLTOT is considered in pa
6、tients with nPaO2 of 7.3kPa when stable ornPaO2 of 7.3 8kPa with one of the following:nsecondary polycytheamiannocturnal hypoxaemia,nperipheral oedema or pulmonary hypertensionnSevere airflow obstruction FEV130%RESPIRATORY NURSESALISON CALVERT RLI/WGH EXT 3608/5611MOBILE 07917240710SARAH JEWELL FGH PAGER VIA SWITCH EXT 1502HELEN BOOTH RLI BLEEP 767 EXT 3608
