University Teaching Trust Bronchiectasis action plan Turnberg Building Respiratory Medicine 0161 206 1604 All Rights Reserved 2016. Document for issue as handout.
Name: Date of Birth: Hospital Number: NHS Number: Date plan started: Contact Numbers General Practitioner (GP surgery) NHS 111 Service 111 Hospital Specialist Team: Dr Michelle Needham Helen Pyne (advanced practitioner) Contact details: Jane Browne 0161 206 5154/5 1 2
My usual symptoms day to day when my condition is stable (not during a chest infection) Tick all the boxes that best represent how you are on most days My usual cough day to day I normally cough most days of the week I normally cough one or two days of the week I normally cough a few days per month I normally cough only with chest infections My usual sputum clearance day to day I normally cough up sputum most days of the week I normally cough up sputum one or two days of the week I normally cough up sputum a few days per month I normally cough up sputum only with chest infections The usual colour of my sputum day to day Clear White Pale yellow or green Dark yellow or green None The usual amount of sputum day to day None 1 teaspoon 1 dessertspoon 1 tablespoon Eggcup Small yoghurt carton Teacup The consistency of my sputum day to day None Creamy Lumpy Watery Thick Sticky Breathlessness day to day I normally get breathless walking around the home I normally get breathless walking outside on the level I normally get breathless walking up a flight of stairs I normally get breathless playing sports I only get breathless with chest infections I never get breathless (except with heavy exertion) Other symptoms I have day to day Wheeze (whistling sound in my chest) Chest tightness Fatigue Chest pain Blood spitting Tiredness Bad taste in my mouth Date when symptom record completed: 3 4
Day to day management of your condition l Clear your chest as advised by your physiotherapist l Take your medication and inhalers, if on them, as prescribed l Never allow medicines to run out l Keep a course of rescue antibiotic at home l Drink plenty of fluids l Eat a healthy balanced diet l Try to stay within recommended weight range l Take regular exercise l Don t smoke (ask for help if needed) l Get your annual flu jab available from October at your surgery l Avoid visiting anyone who is unwell with a cold, flu or chest infection l Ask family and friends not to visit when they are unwell with colds, flu or chest infections l Keep a supply of sputum pots in the house l Know how much sputum you have and its colour, where possible l Know your symptoms and when changes take place l Know what to do when you have a chest infection Ask your GP or Practice Nurse to arrange a sputum test at least once a year (you can get a specimen pot from your surgery) Recommended treatment for infective exacerbation of bronchiectasis (chest infection): Date: Date: Date: Signs of infection (you may have some or all of these) Feeling generally unwell Coughing up more sputum or more difficult to clear Change in the colour of your sputum (for example clear to yellow, yellow to green) New breathlessness or worsening breathlessness New chest tightness or increased chest tightness New chest pain or increased chest pain Actions Clear your chest more often (at least twice daily) Take your regular medication(s) and inhalers, if you have them Drink plenty of fluids Collect sputum sample and hand to GP as soon as possible (if cannot get to surgery that day, keep the sample in the fridge overnight) Seek help if needed Some colds get better without needing antibiotics. If there is no change in the amount or colour of your sputum do not start your antibiotics 5 6
Log of Events Date of Infection Which antibiotic did you take? How long did you take the antibiotic for? Did you get a sputum specimen? Which bug was in your sputum? 7 8
When to seek help Close monitoring of symptoms If you feel that your bronchiectasis is worse but there is no change in the amount or colour or consistency of your sputum You may have an increase in symptoms but don t feel particularly unwell Action: Take a sputum specimen to your GP: Do not start your antibiotics until the results are available. Contact the surgery for the specimen results and write it in your log of events along with any antibiotics that may be needed If no improvement after 48 hours make an appointment for review with your GP Additional services to help and support you with the management of your condition Pulmonary Rehabilitation Salford Pulmonary Rehabilitation Service (Better Breathing) Self refer: 0161 206 3159 or Ask at your surgery or Ask your hospital specialist Newsletter Salford Bronchiectasis Team Bronchiectasis Education and Support Team (BEAST) Newsletter Contact Jane: 0161 206 5154/5 She will add you to the mailing list Self manage and consider routine GP review Emergency GP or 999 If you are feeling unwell and have an increase in the amount and/or change in the colour or consistency of your phlegm and have increased cough, breathlessness or chest tightness/pain or are coughing up small amounts of blood Action: Take a sputum specimen to your GP and start your rescue antibiotics straight away without waiting for the test results and consider a review with your GP. Contact the surgery for the specimen results and write it in your log of events along with the antibiotics you have taken for the infection. If you are coughing up large amounts of blood or are severely breathless or breathless whilst talking or are drowsy or confused Action: Call the emergency GP first. Collect a sputum specimen if possible. Start rescue antibiotics straight away. Don t hesitate to call for an ambulance if you feel very unwell. Respiratory physiotherapy Ask your hospital specialist if you have not seen a physiotherapist or if you need an update of the new techniques available Stop smoking Service Ask at your surgery, practice nurse or GP. Website Bronchiectasis Education and Support Team (BEAST) http://www.srft.nhs. uk/respiratory/ This document has been adapted from the BTS bronchiectasis action plan: British Thoracic Society www.brit-thoracic.org.uk 9 10
G16052003W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2016 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: MED 32 (16) Review Date: November 2018 University Teaching Trust For further information on this leaflet, it s references and sources used, please contact 0161 206 1604. Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Email: InterpretationandTrans@srft.nhs.uk Under the Human Tissue Act 2004, consent will not be required from living patients from whom tissue has been taken for diagnosis or testing to use any left over tissue for the following purposes: clinical audit, education or training relating to human health, performance assessment, public health monitoring and quality assurance. If you object to your tissue being used for any of the above purposes, please inform a member of staff immediately. Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on 0161 206 1779 Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone 0161 789 7373 www.srft.nhs.uk If you would like to become a Foundation Trust Member please visit: www.srft.nhs.uk/ for-members If you have any suggestions as to how this document could be improved in the future then please visit: http://www.srft.nhs.uk/ for-patients