Prevention
It is important to identify and avoid situations where your Asthma might be triggered. This is the best way to reduce your need for medication and to prevent asthma episodes. It would help to learn what triggers your Asthma. Any time you have an Asthma episode, think about where you were and what you were doing the past day or so. Answer questions like these in a diary or on your calendar:
- Was I making a bed or vacuuming?
- Was I near an animal? Cigarette smoke?
- Did I have a cold or other infection?
- Was I running, playing or exercising?
- Was I upset, excited or tired?
Chronic obstructive pulmonary occurs when the lungs become inflamed, damaged and narrowed. The main cause is smoking, although the condition can sometimes affect people who have never smoked. The likelihood of developing COPD increases the more you smoke and the longer you've smoked.
Overview - Asthma
Both adults and children who suffer from asthma will experience times when their breathing becomes more difficult. Some people with more severe asthma may have breathing problems on a regular basis.
Overview - COPD
Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties. Such difficulties which can be encountered include:
- Emphysema – damage to the air sacs in the lungs,
- Chronic bronchitis – long-term inflammation of the airways.
Symptoms
The most common symptoms of asthma are:
- Wheezing (a whistling sound when breathing),
Treatment
The damage to the lungs caused by COPD is permanent, but treatment can help slow down the progression of the condition.
Treatments for Asthma / COPD include the following:
- Stop smoking – if you have COPD and you smoke, this is the most important thing you can do,
- Inhalers and medications can be prescribed to help make breathing easier,
- Pulmonary rehabilitation is a specialised programme of exercise and education,
- Surgery or a lung transplant although this is only an option for a very small number of people.
Clinic
In order to improve risk factor and symptom management of Asthma, during the Practice monitoring clinic the Practice Nurse will aim to focus on improving lung function through regular review of medication and inhaler technique.
Asthma
Patients will be seen at intervals appropriately to their needs until they are controlled:
- Newly diagnosed and poorly controlled patients (as required) until stable,
- Patients requiring hospitalisation – within 2 weeks
- Patients requiring nebulisation - within 2 weeks
- Patients requiring oral steroids – within 2 weeks
- All asthmatic patients within the Practice should be seen at least once a year.
1st follow-up visit
- This should be within 2 weeks of diagnosis,
- Discussion of diagnosis, recent symptoms, patients understanding of condition.
- Measure PF / monitor home recordings of PF
- Check inhaler technique and correct if necessary
- Continue education about asthma, giving appropriate non-promotional literature
- Evaluate treatment and refer back to GP if necessary
- Arrange next follow-up as appropriate.
Checks should include:
- Night Cough – present /absent
- Time off from school / work in last six months
Self – Management Plan
Patients on reliever’s only beta2 agonists or Atrovent may increase inhaler to up to 20 puffs per day. If symptoms persist or inhaler effective for less than 4 hours to contact the GP to commence steroids.
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) can be better known as chronic bronchitis, emphysema or chronic unremitting asthma. The main symptoms associated with the condition are shortness of breath, cough and production of phlegm that may worsen at certain times of the year. COPD is a progressive disease that is largely preventable. Smoking is the main cause of COPD.
Clinical protocol - Aims and objectives
- Prevent disease progression
- Prevent and treat complications
- Prevent and treat exacerbations
- Minimise side effects of treatment
Reduction of risk factors
- Indoor and outdoor pollution
- Determine disease severity
- Implement stepwise plan for therapy
- Treat accordingly to nationally agreed guidelines
Promote effective inhaled therapy
People with stable COPD who remain breathless or have exacerbations despite use of short-acting bronchodilators as required.
Stop Smoking
Encouraging patients with COPD to stop smoking is one of the most important components of their management. All COPD patients still smoking, regardless of age, should be encourages to stop, and offered help to do so, at every opportunity.