【COPD英文PPT课件】COPD.pptVIP

Inhaled Therapy Short acting Beta 2 agonist Short acting Anticholonergic Long acting Beta 2 agonist Long acting Anticholonergic Combination long acting Beta 2 agonist and corticosteroid Oral Therapy Theophyllines Corticosteroids Prophylactic Antibiotics Oxygen Severe patients may require long term oxygen Initial indication is if SpO2 is less than 92% CBG done oxygen ordered if PaO2 is less than 7.3 Kpa Short burst oxygen is given to some patients who are palliative or get symptomatic relief Oxygen Sensitive Patients Some patients are oxygen sensitive providing uncontrolled or high levels of oxygen and cause respiratory acidosis Patients should be on Venturi masks as much as possible to reduce the risk If patients are above the target saturations and are having more oxygen than normal then it is sensible to gradually reduce this down Pulmonary Rehabilitation Exercise programme Twice a week for eight weeks Improve strength and physical fitness Improved quality of life, exercise tolerance and ADLs Reduction in healthcare costs Education and Self Management Exacerbation recognition and management Inhaler technique Breathlessness management Chest clearance Energy conservation Anxiety Management Dietetic advice Non Invasive Ventilation Indicated for patients who have developed respiratory acidosis pH 7.35 Aim to blow off the carbon dioxide and therefore increase pH Normally as a result of respiratory muscle pump failure Severe COPD patients live on edge of respiratory capacity when well Some patients now home ventilated with positive effects Summary Predominantly smoking related disease Characterised by narrowing of the airways causing obstruction Stopping smoking is most important intervention Treatment can slow down progression and symptoms can improve Palliative Care Supportive care in the community for those identified as end stage COPD Facilitation of patients expressing their wishes Timely and appropriate intervention that has been discussed with the patient