Respiratory Medicine - Salford Royal

The Department of respiratory medicine provides specialist services within both the hospital and community setting to the population

The Salford respiratory team is one of 2 centres that led the development of the UK guidelines for emergency oxygen use.

Inpatient services

Ward H2 is the dedicated respiratory ward at Salford Royal. The ward has 25 beds including 13 side rooms and is staffed by an experienced team of specialist respiratory consultants, nurses, physiotherapy and occupational therapy staff and the cardiorespiratory investigation team (CRI)

Respiratory expertise is offered to other specialities across the trust through the inpatient referral system and is offered to the emergency assessment unit (EAU) via the in-reach model.

Patients admitted to ward H2 will also receive expert support form the smoking cessation team as needed.

Additionally, some of our patients may need to be admitted to ward H1 – the medical high dependency unit (MHDU) for increased levels of medical and nursing support.

Together, wards H1 and H2 make up the Respiratory Support Unit (RSU)

Outpatient services

  • Lung cancer clinics
  • General respiratory clinics
  • Severe asthma clinics, including asthma biologics
  • Lung Fibrosis clinic
  • Pleural clinic
  • Tuberculosis (TB) clinic
  • Sleep disorder clinic
  • CPAP clinic
  • Community COPD clinic
  • Post Covid follow up clinic (virtual)
  • Long Covid clinic
  • Specialist cough clinic
  • Bronchiectasis clinic
  • Nodule follow up clinic (virtual)
  • Nebulised drug challenge clinic
  • Lung health check service - click for details
  • Nodule follow up clinic
  • Nebulised drug challenge clinics
  • Lung function testing service

Community

If you are attending an outpatient appointment at the hospital, this section provides you will useful information about your visit.  The information contained in this section is also available in our outpatient patient information leaflet.  

 Arriving for your outpatient appointment 

Our Meet and Greet Service Pilot Scheme for visitors to the main hospital site has been launched.  You can find out more about the service as well as apply for support with a visit to Outpatients using our online registration page. 

 Your outpatient letter will detail which outpatient desk you need to report to and where it is in the hospital. When you book in, your personal details like your address, GP and next of kin will be checked. 

What do I need to bring with me? 

  • your appointment letter 

  • medication - your appointment letter will say what you need to bring  

  • any samples that have been requested 

  • any questionnaires you may have completed 

  • money for prescriptions or an exemption certificate 

  • a list of any questions 

  • proof of UK residency i.e. medical card, passport, UK driving licence, pension book, utility bill, student ID 

  • money for car parking charges 

Your clinic area 

We do our utmost to make sure you are seen on time. However, there may be occasions when changes happen meaning your wait may be longer than usual. If this happens, the clinic staff will tell you. 

During your clinic appointment, you may be asked to have a test so that the doctor has all the information needed to assess you. Please be aware that it is advisable to leave extra time for your visit in case you are required to have a test carried out once the doctor has seen you. 

The doctor may give you a prescription and will tell you if you need to collect it at the hospital pharmacy or if you can go to your local chemist. 

If you have any queries when you are in clinic, the staff there will be happy to help 

Salford Royal, Stott Lane, Salford        

COPD, Chronic bronchitis, and Emphysema

Chronic obstructive pulmonary disease, or COPD, describes a group of lung conditions that make it difficult to empty air out of the lungs because the airways have become narrowed. Two of these lung conditions are long-term bronchitis and emphysema, which can often occur together. . Bronchitis means the airways are inflamed and narrowed. People with bronchitis often produce sputum, or phlegm. . Emphysema affects the tiny air sacs at the end of the airways in your lungs where oxygen gets into your bloodstream. They break down and the lungs become baggy and full of bigger holes which trap air.

These conditions narrow the airways. This makes it harder to move air in and out as you breathe, and your lungs are less able to take in oxygen and get rid of carbon dioxide. The airways are lined by muscle and elastic tissue. In a healthy lung, the springy tissue between the airways acts as packing and pulls on the airways to keep them open. With COPD, the airways are narrowed because: . the lung tissue is damaged so there is less pull on the airways . mucus blocks part of the airway . the airway lining becomes inflamed and swollen

Living_with_COPD_May22_C+C_Digital_Live.pdf (blf.org.uk)

Chronic Asthma

Asthma is a condition that affects the airways – the tubes that carry air in and out of the lungs. If you have asthma, you have ‘sensitive’ airways that are inflamed and ready to react to things that can irritate them. This can include pollen, cold weather, stress and hormones. When the airways react they become narrower and more irritated. This causes you to have asthma symptoms, where you find it harder to breath

easy_read_all_about_asthma_booklet.pdf

live-well-with-asthma_downloadable_5.pdf 

Bronchiectasis

Bronchiectasis is a long-term condition that affects the airways in your lungs. When you breathe, air is carried into your lungs through your airways, also called bronchi. The bronchi divide again and again into thousands of smaller airways called bronchioles. Your airways contain tiny glands that produce a small amount of mucus. Mucus helps to keep your airways moist, and traps the dust and germs that you breathe in. The mucus is moved away by tiny hairs, called cilia, which line your airways. If you have bronchiectasis, your airways are widened and inflamed with thick mucus, also called phlegm or sputum. Your airways may not clear themselves properly. This means mucus builds up and your airways can become infected by bacteria. Pockets in the airways mean that mucus gets trapped and is likely to get infected

Sometimes, if the number of bacteria multiply, you’ll get a chest infection or a flare-up of your symptoms. It’s important to recognise and treat chest infections. If you don’t get treatment, your airways may be damaged further. The changes to your airways can’t be reversed, but there are ways you and your health care team can treat and manage bronchiectasis.

Bronchiectasis_May22_C+C_Digital_Live.pdf (blf.org.uk)

Pulmonary Fibrosis

Pulmonary fibrosis is the end result of many different conditions that cause scar tissue to build up in your lungs and make breathing increasingly difficult. All types of pulmonary fibrosis are considered rare. Pulmonary fibrosis is an interstitial lung disease (ILD). There are more than 200 different ILDs.

  • pulmonary: it affects your lungs .
  • fibrosis: a build-up of scar tissue, which makes your lungs stiff.
  • interstitial: affects your interstitium, the network of tissue that supports air sacs in your lungs

Some types of pulmonary fibrosis have an identifiable cause. But for many types, a definite cause cannot be found, for example idiopathic pulmonary fibrosis.

Interstitial lung diseases cause scarring in your lungs, inflammation in your lungs or a mix of both. Some mostly cause scarring. Some mostly cause inflammation. Often there is a combination of scarring and inflammation. It’s important to know which is the major cause of your symptoms to help decide the best treatment for you. The treatment and outlook for different types of pulmonary fibrosis vary considerably, so if you’re not sure about your diagnosis, check with your doctor or nurse for the exact name of your lung condition.

We do not always know what causes pulmonary fibrosis. We do know it is not a form of cancer or cystic fibrosis, and it is not contagious

Pulmonary fibrosis_May22_C+C-Digital_Live.pdf (blf.org.uk)

Obstructive Sleep Apnoea (OSA)

What is OSA? Obstructive sleep apnoea (OSA) is a breathing problem that happens when you sleep. It’s called OSA because:

  • Obstructive: there’s an obstruction in the airway
  • Sleep: it happens when you’re asleep
  • Apnoea: it means you stop breathing

When you go to sleep your muscles relax, including those in your throat. In some people the relaxing muscles cause the airways to narrow. This can reduce the amount of air flowing in and out of your airways. This makes you snore. If your throat closes completely, you stop breathing for a time. This is called an apnoea if it lasts for 10 seconds or more. If the airways in your throat narrow this is called a hypopnoea. When this happens, there may be a dip in the level of oxygen in your blood. Your brain will start your breathing again. Some people wake up briefly, but others are not aware of what’s happening. Breathing often restarts with a gasp or grunt and some movement. You relax again, and the pattern then starts again. Obstructive sleep apnoea (OSA) blf.org.uk/osa 2 If you have severe OSA, this cycle can happen hundreds of times a night. These frequent arousals disrupt your sleep and so you can feel very sleepy during the day

BK32_OSA_v3_2021_downloadpdf_FULL.pdf (blf.org.uk)

Sleep Apnoea Trust - A patient support charity (sleep-apnoea-trust.org)

Lung cancer

Your body is made up of many different types of cells. Normally, your body tightly controls the production of new cells when they’re needed. Cancer develops when certain cells escape from your body’s control and start to change. These abnormal cells, also called cancer cells, start to increase and grow to form a lump. This is called a tumour. If the cancer starts in your lung, it’s called primary lung cancer. If it starts in another part of your body and spreads to affect your lung, it’s called secondary lung cancer. The lung is a relatively common site for other cancers to spread to. The management and prognosis of secondary lung cancer is different to that of primary lung cancer. There are different types of lung cancer. The main types are: • non small cell lung cancer (NSCLC): This is the most common kind of lung cancer. There are three common types of non small cell lung cancer: adenocarcinoma, squamous cell carcinoma and large cell carcinoma. • small cell lung cancer (SCLC): This is much less common. It usually spreads more quickly and is often at an advanced stage when it’s diagnosed. • mesothelioma (blf.org.uk/mesothelioma): This is a cancer of the lining of the lung (the pleura) and is often associated with asbestos exposure, commonly through work.

FL16 lung cancer v4 downloadable PDF.pdf (blf.org.uk)

Tuberculosis

Anyone can catch TB by breathing in TB bacteria. These bacteria are in tiny droplets in the air coughed out by people with TB in their lung. In most people, if you breathe in TB bacteria your immune system – your body’s natural defence - will control most of the bacteria and you will not get ill. However, if you do become ill, which can happen weeks, months or even years after you breathe in TB bacteria, this is called active TB. In most people, the body’s immune system controls the TB bacteria, which stay in the body at a low level. You won’t get ill and you’re not infectious. This is called latent TB. In about five to ten out of every 100 people with latent TB, the TB bacteria can start to multiply again or reactivate and lead to symptoms of active TB.

TB downloadable PDF V4 2020.pdf (blf.org.uk)

Pleural plaques

Inside your chest there are two thin layers of cells - called the pleura or pleural membrane. Each layer is about as thin as the skin of a balloon. The inner layer covers your lungs and the outer layer lines the inside of your rib cage.  If you have been exposed to asbestos, it’s common for areas of the pleura to become thickened. These areas are called pleural plaques.

It’s thought that around 36,000 to 90,000 people per year develop pleural plaques in the UK. Pleural plaques are considered harmless and many people in the UK have them, often without even knowing about it.

If you have pleural plaques, it doesn’t mean that you will go on to get a more serious disease.

Being exposed to asbestos does increase your risk of developing a serious lung condition such as asbestosis, mesothelioma or lung cancer. But there is no scientific evidence that having pleural plaques increases the risk any further. So, if you’ve been exposed to asbestos you should not worry if you’re told you have pleural plaques.

Pleural plaques aren’t the same as asbestosis and they aren’t a form of cancer

Abestos_and_your_lungs_V4_downloadable_PDF.pdf (blf.org.uk)

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