COPD Management

• • stopping smoking can drastically decrease chances of pulmonary disability and death

  
• Smoking Cessation:

  • Very brief advice (VBA) – 3 As (ASK, ADVISE and ACT)
  • ASK and record smoking status - is the patient a smoker, exsmoker, or non-smoker?
  • ADVISE on the best way of quitting - the best way of stopping smoking is with a combination of medication and specialist support
  • ACT on patient response - give information about local stop smoking service
  • Patients are up to four times more likely to quit successfully with NHS support
  • Healthcare workers have a duty of care to raise this issue – don’t leave to others
• Management of COPD - Drug therapy:

  • Bronchodilators - expands airways -> less resistance to air flow
  • Steroids (anti-inflammatory action)
  • Diuretics (to treat Right ventricular failure –> ankle oedema)
  • Long term oxygen therapy (LTOT) - for patients with chronic hypoxia
  • Antibiotics (for infective exacerbations)
  • Flu vaccine
• Management of COPD - Surgery:

  • Lung Volume Reduction Surgery (LVRS) for emphysema:
  • Remove bullae
  • Relieves compression of healthy lung tissue
  • Lung volume reduced
  • Improved length-tension of diaphragm (domed)
• Bullectomy:

  • Removal of a bullae
• Physiotherapy Management:

  • Education
  • Smoking cessation
  • Inhaler technique and drug action
  • Breathlessness management – at rest and on exertion
  • Sputum clearance techniques if appropriate
  • Pulmonary rehabilitation