Self-Management Plan for COPD

Transcription

1 South Tyneside NHS Foundation Trust Self-Management Plan for COPD This is your personal management plan. The aim of this 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 an exacerbation. An exacerbation is a rapid and sustained worsening of your symptoms that may mean you need a change to your regular treatment. This plan includes sections for recording your medication, monitoring your symptoms and treating exacerbations. Name: Date of birth: Diagnosis/diagnoses: GP practice contact number (Mon to Fri, 8am to 6pm) Outside these hours, phone NHS 111 or the South Tyneside Acute Care Team on Community matron or respiratory nurse service Providing a range of NHS services in Gateshead, South Tyneside and Sunderland.

2 Usual COPD symptoms when WELL Breathlessness score Please record the breathlessness score (see below) that describes your symptoms when you are well. Medical Research Council (MRC) breathlessness scale Grade 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 Usual respiratory medications Inhaler/tablet name Preparation Dose and frequency Walks slower than contemporaries on level ground 3 because of breathlessness or has to stop for breath when walking at own pace Stops for breath after walking about 100m or after a Do you have any allergies? few minutes on level ground If so, allergy to what? 5 Too breathless to leave the house, or breathless Do you have oxygen at home? when dressing or undressing What is your daily rate? Date: MRC Score: How do you keep well... Sputum production Take daily exercise The normal colour of your sputum is How much sputum do you produce each day? Eat a good balanced diet Drink plenty of liquids (not alcohol) Do not smoke, and avoid smoky places Cough Do you normally have a cough? Plan ahead and have things to look forward to Swollen ankles Do your ankles normally swell? Always have enough medications so you never run out Take all medication regularly as prescribed whether you think they help at the time or not Exercise How far can you normally walk? Make sure you get your annual flu vaccination. 1 2

3 Your COPD may be GETTING WORSE if you have any of the following symptoms... More breathless than usual An increase in the amount or change in colour of your sputum A new or increased cough New or increased ankle swelling More frequent use of reliever medication Less able to do your normal activities or they are taking longer because of your shortness of breath You feel hot and have a temperature What action to take if your COPD symptoms are getting worse: Increase reliever medication to help your breathlessness Balance activity with plenty of rest Eat little and often Drink plenty of fluids eg. water Continue to monitor your symptoms closely. If your symptoms improve within two days, continue your usual medication If they are no better or getting worse after two days, continue with the increased dose of medication which relieves your breathlessness and contact your GP or respiratory nurse If an increase in medication which relieves your breathlessness doesn t improve your symptoms start with your rescue medication (see page 4) What to do if you have an EXACERBATION? An exacerbation is a rapid and sustained worsening of your symptoms that may mean you need a change to your regular treatment. Contact your GP (or Acute Care Team or dial NHS 111) Contact your respiratory nurse (ARAS) or community matron Start taking your standby supply of steroids and/or antibiotics Rescue medication (see also page 5) Steroids (prednisolone) If you are much more breathless than normal, and your daily living activities are affected, continue with increased medication which relieves your breathlessness and start taking prednisolone which will already have been prescribed for you. Dose of prednisolone 30mg once a day for five days Antibiotics If the colour of your sputum changes from your normal colour start your antibiotics which will already have been prescribed for you. Preparation: Dose: Remember: Contact your GP, or Community matron or nurse respiratory service if you do not start to feel better after three days of treatment Contact your GP, or Community matron or nurse respiratory service if you take more than one course of standby steroids and antibiotics in one month 3 4

4 EMERGENCY symptoms of COPD Urgent call 999 Extremely short of breath with no relief from inhalers Chest pain High fever Feeling of agitation, drowsiness, panic or confusion. An exacerbation diary Date Treatment used Hospital admission or community nurse who visited Contact your GP surgery immediately or, when the surgery is closed, phone NHS 111. In case of extreme emergency, dial 999 for an ambulance. Have you used your rescue medication? If not, do so now. If you have had two exacerbations within the last year please arrange an appointment with your respiratory nurse. Contact: 5 6

5 For further information contact: South Tyneside Acute Care Team South Tyneside Acute Respiratory Assessment Service (ARAS) This booklet has been produced in partnership with: We are committed to raising the standard of written information for patients, their carers, people who use the NHS and the general public. This information can be made available in another format or language on request. Production date: Jan 2014 Author: Consultant Respiratory Physician Code: 0114/362 Review date: Jan 2017 With thanks to NHS Forth Valley and West Lothian CHCP