Rain, wind and self-management
It's been a busy couple of weeks with no let-up in the weather. As we went from wet and windy to a short cold snap, many A&Es were stretched.
Here at the Homerton University Hospital, we found many patients with chronic obstructive pulmonary disease (COPD) struggling. As they experienced flare-ups due to the weather, there was an increase in hospital admissions and calls to our hospital-at-home team.
It is vital that people living with COPD understand the early warning signs of an exacerbation (and where appropriate have standby rescue medication as part of a self-management plan). But do all healthcare professionals know what these are?
Some people living with COPD I talk to say they don’t get the ‘right’ treatments as many healthcare professionals pass off an acute exacerbation as a common cold or flu. NICE (2010) suggests that an exacerbation occurs when there is a ‘rapid and sustained worsening of the patient’s symptoms beyond normal day-to-day variations’.
The recommendation is prompt treatment with oral corticosteroids for serious breathlessness that interferes with activities of daily living, plus appropriate antibiotic treatment for any change in sputum, such as when it becomes purulent in nature and colour, alongside adjusting bronchodilator therapy to manage symptoms (NICE 2010).
In my experience this combination is often started together - but a good clinical history, listening to your patients describe their symptoms compared to a ‘baseline’, is valuable.
More information for healthcare professionals on COPD management can be found on the NICE website.
The British Lung Foundation (BLF) also produces some really informative patient information around what exacerbations are, along with what to expect when you go for an appointment.
This is really putting control back in the hand of patients as those with COPD are the experts. Much of the literature that the BLF produces is free and that is why I have chosen to support this charity to help it continue this valuable work and ensure that respiratory patients have access to up-to-date, accurate information.
I am raising money by trekking the Great Wall of China, and over the past couple of weeks I’ve been writing to a number of leading companies and organisations in the respiratory world, seeking sponsorship for my trek. A colleague of mine suggested that I should have hand-delivered each of the letters as part of my ongoing training!
I am grateful to the nursing community for the support so far and I hope to continue to promote the amazing work of the BLF. The organisation really does need all our support. The barometer on my donation page is increasing but I would welcome more donations, however small. For more information, visit my Virgin Money Giving page
About the author
Matthew Hodson is a nurse consultant at the Homerton University Hospital in Hackney, east London
You can follow Matt on Twitter @speak2matt