Respiratory - Bronchiectasis Action Plan

Name:

Date of Birth:

Hospital number:                                         

NHS Number:             /             /                 

Date Plan Started:

Hospital Specialist Team:

Dr Michelle Needham
Helen Pyne (Advanced Practitioner)
Tina Wilding (Respiratory Nurse)
Respiratory Secretary, contact: 0161 206 5154/5

My usual symptoms day to day when my condition is stable (not during a chest infection)

Tick all the boxes that best represent how you are on most days

Date when symptom record completed:

Day to day management of your condition

• Clear your chest as advised by your physiotherapist
• Take your medication and inhalers, if on them, as prescribed
• Never allow medicines to run out
• Keep a course of rescue antibiotic at home
• Drink plenty of fluids
• Eat a healthy balanced diet
• Try to stay within recommended weight range
• Take regular exercise
• Don’t smoke (ask for help if needed)
• Get your annual flu jab available from October at your surgery
• Avoid visiting anyone who is unwell with a cold, flu or chest infection
• Ask family and friends not to visit when they are unwell with colds, flu or chest infections
• Keep a supply of sputum pots in the house
• Know how much sputum you have and its colour, where possible
• Know your symptoms and when changes take place
• Know what to do when you have a chest infection 

Ask your GP or Practice Nurse to arrange a sputum test at least once a year (you can get a specimen pot from your surgery)

Recommended treatment for infective exacerbation of bronchiectasis (chest infection):

Date:

Date:

Date:

Signs of infection (you may have some or all of these):

• Feeling generally unwell
• Coughing up more sputum or more difficult to clear
• Change in the colour of your sputum (for example clear to yellow, yellow to green)
• New breathlessness or worsening breathlessness
• New chest tightness or increased chest tightness
• New chest pain or increased chest pain

Actions:

• Clear your chest more often (at least twice daily)
• Take your regular medication(s) and inhalers if you have them
• Drink plenty of fluids
• Collect sputum sample and hand to GP as soon as possible (if you cannot get to surgery that day, keep the sample in the fridge overnight)
• Seek help if needed
• Some colds get better without needing antibiotics. If there is no change in the amount or colour of your sputum do not start your antibiotics

Close Monitoring of symptoms

If you feel that your bronchiectasis is worse but there is no change in the amount or colour or consistency of your sputum.

You may have an increase in symptoms but don’t feel particularly unwell.

Action: Take a sputum specimen to your GP: Do not start your antibiotics until the results are available. Contact the surgery for the specimen results and write it in your log of events along with any antibiotics that may be needed If no improvement after 48 hours make an appointment for review with your GP.

Self-manage and consider routine GP review

If you are feeling unwell and have an increase in the amount and/or change in the colour or consistency of your phlegm and have increased cough, breathlessness or chest tightness/pain or are coughing up small amounts of blood.

Action: Take a sputum specimen to your GP and start your rescue antibiotics straight away without waiting for the test results and consider a review with your GP. Contact the surgery for the specimen results and write it in your log of events along with the antibiotics you have taken for the infection.

Emergency GP or 999

If you are coughing up large amounts of blood or are severely breathless or breathless whilst talking or are drowsy or confused.

Action: Call the emergency GP first. Collect a sputum specimen if possible. Start rescue antibiotics straight away. Don’t hesitate to call for an ambulance if you feel very unwell.

Additional services to help and support you with the management of your condition

Pulmonary Rehabilitation

Salford Pulmonary Rehabilitation Service (Better Breathing)

Self-refer: 0161 206 3159 or ask at your surgery or ask your hospital specialist

Respiratory physiotherapy

Ask your hospital specialist if you have not seen a physiotherapist or if you need an update of the new techniques available.

Stop smoking Service

Ask at your surgery, practice nurse or GP.

This document has been adapted from the BTS bronchiectasis action plan:

British Thoracic Society
www.brit-thoracic.org.uk