Self-management plan for COPD

Transcription

1 Sheffield Clinical Commissioning Group Sheffield Teaching Hospitals NHS Foundation Trust Self-management plan for COPD This is your personal management plan The aim of the plan is to help you have better control of your Chronic Obstructive Pulmonary Disease (COPD). It will enable you to monitor your symptoms and to know what to do if you have a flare up (exacerbation). An exacerbation is an acute and sustained worsening of your symptoms for which you may need changes to your regular treatment. Name: Date of birth: Diagnosis / diagnoses: GP Practice contact number: Community Nurse Name: Contact number: In hospital and in the community proud to make a difference

2 Usual symptoms when well Breathlessness score Please record the MRC breathlessness score (see below) that describes your symptoms when you are well. Date: Score: Medical Research Council (MRC) breathlessness scale Grade Sputum Production (phlegm) The normal colour of your sputum is How much sputum do you produce each day? Cough Degree of breathlessness related to activities 1 Not troubled by breathlessness except on strenuous exercise 2 Short of breath when hurrying or walking up a slight hill 3 Walk slower than contemporaries on level ground because of breathlessness or has to stop for breath when walking at own pace 4 Stops for breath after walking about 100m or after a few minutes on level ground 5 Too breathless to leave the house, or breathless when dressing and undressing Do you normally have a cough? 2 Swollen ankles Do you normally have ankle swelling?

3 Usual respiratory medications Inhaler/tablet name Dose and frequency Device How do I keep well? Eat a good balanced diet Drink plenty of fluids (not alcohol) Do not smoke, and avoid smoky environments (stopping smoking is one of the most important things you can do. Contact your GP Practice or Sheffield Stop Smoking Service for help and advice) Always have a supply of medications. Never run out Take all medications as prescribed Make sure you get your annual flu vaccination Make sure you get your pneumonia vaccination Avoid contact with family or friends with colds Attempt to do some exercise every day Attend Pulmonary Rehabilitation 3

4 Pulmonary Rehabilitation This is an individualised programme of exercise and education for people with breathing conditions. It aims to improve exercise capacity and overall management of long term breathing conditions. Have you been referred to or attended pulmonary rehabilitation? Yes / No If Yes Date Referred Date when last attended If not ask for a referral by your doctor, nurse or physiotherapist Oxygen Levels My usual oxygen levels when I am well are on air or on my usual oxygen therapy. Oxygen Therapy (this treatment is only given following assessment for those with low oxygen levels, not for relief of breathlessness). My normal oxygen rate is l/min for hours per day or on activity. 4 All patients on oxygen therapy should have follow up from the oxygen service at least every year, either in clinic or by telephone. Changes to oxygen therapy should only be made by the oxygen service or hospital doctor following assessment.

5 How to recognise if you are having a COPD flare up (exacerbation) and what to do Two or more of the following symptoms can indicate a flare up: More breathless than usual An increase in the amount and / or change in colour of your sputum A new or increased cough Wheeze and / or chest tightness Increased tiredness Loss of appetite Less able to do your normal activities or they are taking longer What action to take if you have signs of a flare up: Increase reliever medication Contact your GP / Practice Nurse / Community Nurse If you have standby flare up medication (steroids / antibiotics) - take as advised Balance activity with plenty of rest Eat little and often Drink plenty of fluids (not alcohol) Stay calm and relaxed as getting anxious will make your breathing worse 5

6 Standby medication Steroids If you are much more breathless, wheezy and your daily activities are affected, continue increased reliever medication and start taking: mg of for days If you do not have steroids at home contact your GP / Nurse. Antibiotics If the colour and / or amount of your sputum changes from your normal, start taking: mg of, times daily for days If you do not have antibiotics at home contact your GP / Nurse. If you experience a flare up of COPD, and start taking your standby medication, always let your doctor or Nurse know. 6

7 Emergency symptoms of COPD Extremely short of breath with no relief from your inhalers Chest pain High fever Agitation Drowsiness New or increased confusion You can't cope at home If you have any of the above symptoms contact: Your GP surgery immediately In case of extreme emergency, dial 999 for an ambulance Remember: If you do not start to feel better after two days of treatment you need to contact your doctor or nurse. If you have an oxygen alert card don't forget to tell the doctor, nurse, ambulance service or hospital. 7

8 Useful information Yorkshire Smokefree Sheffield Quitting can be hard, but it's easier with specialist support. Yorkshire Smokefree Sheffield can help in lots of ways depending on your preference and what's available in your area. Call: See: (free from landlines) (free from most mobiles) Breathe Easy Sheffield Support Group Make new friends who know what you're going through, and learn more about living with a lung condition. When: 2nd Wednesday of every month Time: 1.30pm pm Where: Graves Health and Sports Centre, Bochum Parkway, Sheffield S8 8JR Call: rgvscot@aol.com See: breathe-easy- sheffield-support-group British Lung Foundation The British Lung Foundation exists to provide information and support for everyone living with a lung disease and for the people who look after them. Call: See: (local rate) With thanks to NHS Lothian for permission to adapt their COPD self-management plan. Alternative formats may be available on request. Please alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust PD7956-PIL3330 v3 Issue date: Sept Review date: Sept 2019