Explanation of asthma Flashcards
What structure would you follow to explain a diagnose to someone?
BUCES
- Brief history
- Understanding
- Concerns
- Explanation
- Summarise
How would you structure your explanation?
- Normal anatomy and physiology
- What the disease is
- Cause
- Problems or complications
- Management
What is important in the concerns portions of BUCES?
ICE!!
How would you signpost your going to start explaining a disease?
“I’m going to begin by talking about how the lungs work and then move on to discuss what asthma is, what causes it and how we can manage it together.”
How would you explain the normal anatomy and physiology?
“When you breathe in, air travels from your mouth down deep into your lungs through a sequence of smaller and smaller tubes that resemble the branches of a tree. When the air reaches the smallest of these tubes, your body absorbs the oxygen from the air into your blood. Oxygen is then used to power all of the cells in your body.”
How would you explain what asthma is?
“Asthma is one of the most common lung conditions. People with asthma have sensitive and inflamed airways that can become narrower than normal.”
“The most common symptoms include coughing, wheezing, chest tightness and shortness of breath. You may not have all of these symptoms at the same time.”
“The symptoms of asthma tend to come and go, often in response to specific things known as triggers.”
“It is important to take asthma medication every day, even if you are feeling well, as this reduces the chance of you getting symptoms or becoming unwell.”
How would you explain what the cause of asthma is?
“We don’t know the exact cause of asthma, although some things make people more likely to get asthma, such as having other allergies or having a family history of asthma.”
“Most people tend to develop asthma as a child, but it can start in adulthood too.”
“The symptoms of asthma are caused by intermittent narrowing of the small tubes within the lungs. This makes it harder for air to move in and out of your lungs, causing you to feel tight chested and short of breath. Sometimes the narrowed tubes cause the air to whistle as it moves through them, like the wind in a tunnel – this is called a wheeze. The narrowing of your airways can also cause irritation, leading to a cough.”
“These symptoms tend to occur in response to specific triggers. Asthma can have many triggers, but some common ones include allergies (e.g. to pollen, pets or food), infections, stress, smoking and sudden temperature changes. It is important to try and work out what triggers your asthma, as it will be different for different people. Avoiding your triggers is a key part of managing asthma.”
How would you explain the acute problems or complications of asthma?
“Sometimes people with asthma experience a worsening of their symptoms that may not improve when they use their inhalers, this is commonly called an “asthma attack” or “asthma exacerbation”. It is important to manage this appropriately as they can potentially be life-threatening.”
“Signs of an asthma attack include: wheezing a lot, having a very tight chest, coughing a lot, finding it difficult to walk or talk due to breathlessness, breathing quickly or your reliever inhaler not helping your symptoms. You may have all of these or just some of them, for example, you may not have a wheeze.”
“If you are experiencing worsening symptoms and find that your reliever inhaler isn’t helping you should call 999. If your reliever inhaler helps your symptoms, you should contact your GP for an urgent review of your asthma. You may need extra medication to treat this worsening of symptoms, for example, a short course of steroid tablets to help settle the inflammation.”
How would you explain the problems or complications of persistent symptoms in asthma?
“It is important to take your asthma medication every day, no matter how well you feel. This is because the protection builds up in your airways and helps to prevent you from experiencing symptoms or asthma attacks in response to triggers.”
“If you experience symptoms frequently despite following your treatment plan you should seek a review from your GP or asthma nurse, who may alter your medications to try and improve your symptoms. You should also make sure to seek a review if your daily activities are being affected by symptoms, you find that you are waking up in the night with asthma symptoms or your peak flow readings are lower than normal.”
“A small number of people with asthma will have severe asthma and may experience frequent symptoms that are hard to control, but the majority of people will find their asthma is well managed with a preventer inhaler and reliever inhaler.”
How would you explain the management of asthma?
The aims of asthma management include:
- No daytime symptoms
- No night-time waking due to asthma
- No asthma attacks
- No limitations on activity including exercise
- Minimal side effects from medication
Overview of asthma management
How would you explain relievers?
“You will be given a reliever inhaler, the most common one is salbutamol and it is typically blue. This is used to help relieve asthma symptoms and asthma attacks. It works by helping to relax the airways when they become narrow.”
“If your asthma is well-controlled you shouldn’t need to use this more than three times a week. If you are needing to use it more than this you should request a review of your asthma with your GP.”
“You should take two puffs of this, with 30 seconds in between, when you feel short of breath.”
How would you preventers relievers?
“You will also be prescribed a preventer inhaler. This helps in the long-term to reduce the inflammation in your airways and makes them less likely to narrow in response to triggers.”
“You should inhale…(x puffs…x times a day) every day. It is really important to try not to miss any doses.”
“You should also make sure to rinse out your mouth after using this as you can sometimes develop a sore, inflamed mouth when taking it.”
How would you explain personalised asthma management?
“It is recommended that anyone with asthma has a personal management plan. It tells you and other people what your normal asthma medicines are, what to do if your symptoms are getting worse and what to do in an emergency situation.”
“A management plan is helpful because it gives you more control over the management of your asthma and can help to prevent asthma attacks from happening.”
“You should book a review appointment with your GP or asthma nurse in a couple of weeks to complete your management plan. You can find examples online, such as on the asthma UK website.”
What other aspects of asthma should you consider?
“You should aim to have a review of your asthma with your GP at least once a year, even if you are completely well. This will make sure that your asthma is well controlled, and you know what to do if your symptoms get worse. If you are having problems with your asthma, you may need reviewing more regularly than this.”
“It is also really important to make sure you are up to date on your vaccinations and that you get your flu jab each year. As a patient with asthma, you are entitled to this for free. This is important as the flu virus is a very common trigger for asthma symptoms and people with asthma can become very unwell with flu.”
How would you summarise the consultation?
“We have discussed quite a lot today, including what asthma is, the symptoms you might experience and how the condition is managed. I realise this is a lot of information to take in and therefore I have a leaflet which summarises everything we’ve discussed. You will require regular checks to ensure your asthma continues to be well controlled. It is also important that you seek a review if you notice your symptoms worsening. If you begin to feel very short of breath, despite using your treatments, you should call an ambulance.”
“Going forward, it is important that following this appointment you attend an inhaler check appointment with a specialist asthma nurse to make sure your inhaler technique is correct. You will also need an appointment to complete an asthma management plan. It is very important that you stick to the asthma plan and use your preventer inhaler even when you are feeling well in order to get the full benefit of treatment.”
“Is there anything I have explained that you’d like me to go over again?”
“Do you have any other questions before we finish?”
