GINA & GOLD guidelines

Hi Kirara, you can find the GINA guidelines for diagnosis and management of asthma in children 5 years and younger at http://www.ginasthma.com/download.asp?intId=380 and GOLD guidelines for diagnosis, management, and prevention of COPD at http://www.goldcopd.com/download.asp?intId=504

Please take note that these files are not meant for commercial purposes and are strictly for personal, clinical or academic use only.

Speech disorders

click here to download

Fluid management

click here to download

Breathing

Click here to download

COPD (treatment)

Smoking cessation

· Since smoking is the main cause for COPD, stopping is definitely the treatment option. This has proved to prolong the survival in patients with COPD.

· Although lost lung function is not regained, the lung damage stops. (rate of FEV₁ reverts back to that of non-smokers)

· For those who can’t stop smoking without an aid, replacement therapy such as nicotine patch, gum or inhaler helps to some certain extend. (user dependant)

· Oral medication to help smoking cessation is another alternative. (e.g. bupropion)

Bronchodilators

· These are medications used to enlarge a narrow airway by action of relaxing the muscles around the airway.

· There are short acting (medication that last only a short period of time after use) & long acting bronchodilators.

· The bronchodilators are in inhaler or oral preparations. (However, inhaled medications have fewer side effects)

· Examples are ipratropium (short acting) and salmeterol (long acting). Theophylline’s use is limited due to its’ narrow therapeutic range. (this means that the individual taking this medication is at a higher risk of getting toxic levels of the medication thus increasing the adverse effects)

Oxygen

· This therapy can be given at home (if the equipment and operator skills are available).

· The therapy shows reduced symptoms & improved survival in patients with COPD. (provided they have stopped smoking)

· The oxygen saturation (Sa_O2) is best kept above 90%.

Lung transplant

· This is only done if all methods of treatment above are tried and have failed & the function of the lung is severely low.(FEV₁ is less than 25%)

Lung volume reduction surgery

· Still another method used to help patients with COPD.

· However, this is a highly specific treatment for a selected group of COPD patients.

COPD (signs & symptoms)

Do you have COPD?

Symptoms of COPD

- symptom is the change in the body's structure, function, or sensation, experienced by the patient & indicative of disease.

1. cough with phlegm
2. breathlessness on mid exertion
3. wheeze (breathing with difficulty & noisily)

Signs of COPD

- sign is an objective indication of disease, discoverable on examination of the patient (usually) by a physician.

- early signs

1. wheezing upon exhalation

- late signs

1. tachypnoea (rapid breathing-the definition varies with the age of the patient)
2. hyperinflated chest (over expansion / distension of chest)
3. marked widespread wheeze
4. 'Pink puffers' or 'blue bloaters'

Cardiac murmurs

Click here to download