Respiratory disease in practice - 2011


Use of NAC in idiopathic pulmonary fibrosis
Timothy Howes
pp 1-4
Idiopathic pulmonary fibrosis (IPF) (often known as cryptogenic pulmonary fibrosis and previously as fibrosing alveolitis, in the UK) has a poor prognosis, comparable with many cancers. In the USA, as many patients with IPF die each year as die from breast cancer. The nomenclature of the disease may be hard to follow, making the diagnostic pathways and management strategies in guideline protocols difficult to implement. The most common histological type of IPF is usual interstitial pneumonia (UIP).
Comment: Computed tomography – to CT or not to CT?
Philip W Ind
pp 3-3
People are frightened of radiation – as highlighted by media hysteria around the recent Japanese nuclear reactor meltdown. However, the dangers are poorly understood and difficult to explain.
Translating evidence into practice – the revised BTS asthma guidance
David T Williams
pp 5-6
Asthma is a significant burden on both the individual and the NHS, commanding significant resources in time and money. In the current environment, the debate around best practice and the delivery of measurable quality benefits and outcomes means that the application of evidence-based practice is in the process of being tested as never before. The publication of the updated Scottish Intercollegiate Guidelines Network (SIGN)/British Thoracic Society (BTS) British Guideline on the Management of Asthma comes against the backdrop of the biggest debate on the future of the NHS in a generation.
BTS guidance – a nursing perspective
Samantha Prigmore
pp 7-7
An estimated 5.4 million people in the UK are receiving treatment for asthma, with 67,077 hospital admissions for asthma in England in 2006–07, over 40% of which were for children under the age of 15. In 2008, there were 1,071 deaths in England and Wales due to asthma. It is estimated that asthma affects one person per five households, and accounts for at least 12.7 million workdays lost each year.
The new respiratory strategy from the Department of Health
Joel Barrick
pp 8-9
On 18 July 2011, the Department of Health (DH), under the Health Secretary, Andrew Lansley, launched its long-awaited guidance, An Outcomes Strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England. It aims to improve the care of COPD and asthma patients, working towards the larger aim of delivering ‘health outcomes that are among the best in the world’, following the findings of the Marmot Review, which confirmed that many influences (including gender, ethnicity, income and psychosocial factors) affect health outcomes.
The importance of proper assessment when prescribing oxygen
Jo Riley
pp 10-11
Patients with chronic respiratory and cardiac diseases may develop respiratory failure, becoming hypoxic with or without raised carbon dioxide levels. Home oxygen therapy is only indicated for treating hypoxic patients. Preterm babies, palliative care patients and, occasionally, those with neurological problems may also be prescribed oxygen. Many different healthcare professionals can prescribe oxygen; however, it is recommended that all patients should receive appropriate assessment before oxygen prescription.