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Authors & contributors
Contents
Foreword
The COPD-X guidelines
Levels of evidence
Summary of the COPD-X guidelines
Confirm
diagnosis &
assess severity
Optimise function
Prevent deterioration
Develop support network
Manage eXacerbations
Appendices
References
References reviewed but not cited
Contents
Contents
Authors and contributors
Contents
Foreword
The COPD guidelines
Levels of evidence
Summary of the COPDX guidelines
C: Confirm diagnosis and assess severity
C1.
Aetiology and natural history
C2.
Diagnosis
C2.
1
History
C2.
2
Physical examination
C2.
3
Spirometry
C2.
4
Flow volume tests
C3.
Assessing the severity of COPD
C4.
Assessing acute response to bronchodilators
C4.
1
Confirm or exclude asthma
C5:
Specialist referral
C5.
1
Complex lung function tests
C5.
2
Exercise testing
C5.
3
Sleep studies
C5.
4
Chest x-rays
C5.
5
High resolution computed tomography
C5.
6
Ventilation and perfusion scans
C5.
7
Transcutaneous oxygen saturation
C5.
8
Arterial blood gas measurement
C5.
9
Sputum examination
C5.
10
Haematology and biochemistry
C5.
11
Electrocardiography and echocardiography
C5.
12
Trials of Therapy
O: Optimise function
O1.
Inhaled bronchodilators
01.
1
Short-acting bronchodilators
01.
1.1
Short-acting beta-agonists
01.
1.2
Short-acting anticholinergics
01.
1.3
Short-acting bronchodilator combinations
01.
2
Long-acting bronchodilators
01.
2.1
Long-acting beta-agonists
01.
2.2
Long-acting anticholinergics
01.
2.3
Long-acting bronchodilator combinations
01.
3
Assessment of response and continuation of bronchodilator therapy
02.
Oral bronchodilators
02.
1
Methylxanthines
02.
2
Phosphodiesterase type-4 inhibitors
O3.
Glucocorticoids
O3.
1
Oral glucocorticoids
O3.
2
Inhaled glucocorticoids
O4.
Inhaled combination therapy
O4.
1
Inhaled glucocorticoids and long-acting beta-agonists in combination
O4.
2
Inhaled glucocorticoids and long-acting beta-agonists and long-acting anticholinergics in combination
O5:
Inhaler technique
O6:
Non-pharmacological interventions
O6.
1
Physical activity
O6.
2
Exercise training
O6.
3
Education and self-management
O6.
3.1
Psychosocial support
O6.
4
Pulmonary rehabilitation
O6.
5
Chest physiotherapy (Airway clearance techniques)
O6.
6
Nutrition
O7.
Co-morbidities & drug safety
O7.
1
Aspiration
O7.
2
Gastro-oesophageal reflux
O7.
3
Alcohol and sedatives
O7.
4
Sleep related breathing disorders
O7.
5
Osteoporosis
O8.
Hypoxaemia and pulmonary hypertension
O8.
1
Treatment
O9.
Surgery
O9.
1
Bullectomy
O9.
2
Lung volume reduction surgery
O9.
3
Lung transplantation
O10.
Palliation and end of life
O10.
1
Opioids
O10.
2
Advanced Care Plans
O10.
3
Palliative oxygen therapy for dyspnoea
P: Prevent deterioration
P1.
Risk factor reduction
P1.
1
Smoking cessation
P1.
1.1
Nicotine replacement therapy
P1.
1.2
Bupropion
P1.
2
Prevent smoking relapse
P2.
Influenza vaccination
P3.
Pneumococcal vaccination
P4.
Haemophilus influenzae vaccination
P5.
Immuno-modulatory agents
P6.
Antibiotics
P7.
Anticholinergics
P8.
Glucocorticoids
P9.
Mucolytic agents
P10.
Regular review
P11.
Oxygen therapy
P11.
1
Fitness to fly
D: Develop support network and self-management plan
D1.
Support team
D1.
1
General
D1.
2
Nurse/respiratory educator
D1.
3
Physiotherapist
D1.
4
Occupational therapist
D1.
5
Social worker
D1.
6
Clinical psychologist
D1.
7
Speech pathologist/therapist
D1.
8
Pharmacist
D1.
9
Dietitian
D1.
10
Non-medical care agencies
D2.
Multidisciplinary care plans
D3.
Self-management plans
D3.
1
Maintenance therapy
D3.
2
Exacerbations and crises
D4.
Treat anxiety and depression
D5.
Referral to a support group
D6.
End-of-life issues
X: Manage eXacerbations
X1.
Home management
X2.
COPD acute exacerbation plan
X2.
1
Initial assessment of severity
X2.
2
Optimise treatment
X3.
Refer appropriately to prevent further deterioration (‘P’)
X3.
1
Controlled oxygen delivery
X3.
2
Non-invasive positive pressure ventilation
X3.
3
Invasive ventilation (intubation)
X3.
4
Clearance of secretions
X3.
5
Monitor and review
X3.
6
Pulmonary rehabilitation
X3.
7
Discharge planning
X3.
8
Support after discharge
X3.
9
Clinical review and follow-up
Appendices
Appendix 1
Appendix 2
Appendix 3
Initiating oxygen therapy
What the patient needs to know
Review
Dangers
Choosing the right method
References
References 1 - 50
References 51 - 100
References 101 - 150
References 151 - 200
References 201 - 251
References 251 - 286
References reviewed but not cited
Content last updated:
April 2009
Page last updated:
April 14, 2009
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