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COPD - Coggle Diagram
COPD
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Oxygen therapy
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ongoing O2 saturations of 92% or less on air, very severe or severe airflow obstruction, cyanosis, polycythaemia, peripheral oedema, raised JVP
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palliative O2 therapy maybe considered by specialist for people with intractable breathlessness which is not responding to treatment
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Self management
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non pharmacology methods including diet, exercise, rehab, smoking cessation
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appropriate use of inhaler, technique and adherences
early recognition and management of exacerbations including: how to adjust short acting bronchodilator, when to take short course steroids and ABX
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Diagnosis of COPD
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suspected in people aged over 35 years old with risk factors and one or more of the following symptoms: breathlessness - typically persistent, progressive over time and worse on exertion, chronic or recurrent cough, regular sputum production, frequent LRTI, wheeze
other symptoms maybe present: weight loss, anorexia and fatigue - common in severe COPD. waking up breathless at night, ankle swelling, - uncommon chest pain and haemoptysis
examination maybe normal, signs may include: cyanosis, raised JVP and or peripheral oedema, cachexia, hyperinflation of chest, use of accessory muscles and or pursed lip breathing, wheeze and or crackles on chest
spirometry is required to confirm DX: FEV1/FVC less that 0.7 confirms persistent airflow obstruction
MDT
consider referral to physiotherapist for people with excessive sputum#, to learn how to use expiratory pressure devices and for active cycle of breathing techniques
consider referral to social services and OT if the person is experiencing difficulty with activities of daily living or functional disability
consider referral for diabetic advise of BMI is abnormal or changing overtime, other causes of unintentional weightloss should be considered, nutrition should form part of all pulmonary rehabilitation programmes
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Definition
COPD is the preferred term for chronic bronchitis, emphysema and chronic airway obstruction. This is commonly treatable but not curable, but largely preventable lung disease. This is caused by airflow obstruction from exposures or noxious particle or gases such as tobacco or environmental factors.
Cor pulmonale
suspected in people with peripheral oedema, raised JVP, systolic parasternal haeve, loud lung pulmonary second heart sounds, hepatomegaly, other caused of peripheral oedema should be considered.
(R) sided HF, secondary to lung disease, caused by pulmonary HTN, as a consequence of hypoxia
rehabilitation
refer for pulmonary rehabilitation if the person is functionally disabled by COPD, or have had recent admission for acute exacerbations