The video version of this podcast can be found here: https://youtu.be/o_q8TTra3Ys This video makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode, I go through the section on diagnosis and initial assessment of the NICE guideline [NG115] on COPD in adults, always focusing on what is relevant in Primary Care only. I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Apple podcast: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148· Spotify: https://open.spotify.com/show/2kmGZkt1ssZ9Ei8n8mMaE0?si=9d30d1993449494e· Amazon Music: https://music.amazon.co.uk/podcasts/0edb5fd8-affb-4c5a-9a6d-6962c1b7f0a1/primary-care-guidelines?ref=dm_sh_NnjF2h4UuQxyX0X3Lb3WQtR5P· Google Podcast: https://www.google.com/podcasts?feed=aHR0cHM6Ly9mZWVkcy5yZWRjaXJjbGUuY29tLzI1ODdhZDc4LTc3MzAtNDhmNi04OTRlLWYxZjQxNzhlMzdjMw%3D%3D· Redcircle: https://redcircle.com/shows/2587ad78-7730-48f6-894e-f1f4178e37c3 There is a YouTube version of this and other videos that you can access here: ● The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The resources consulted can be found here:Chronic obstructive pulmonary disease in over 16s: diagnosis and management- NICE guideline [NG115]:● https://www.nice.org.uk/guidance/NG115The visual summary for the treatment of COPD can be found here:● https://www.nice.org.uk/guidance/ng115/resources/visual-summary-treatment-algorithm-pdf-6604261741The COPD Assessment Test score or CAT score can be found here:● https://www.catestonline.org/hcp-homepage/clinical-practice.htmlThe 6-minute walk test calculator can be found here:● https://www.omnicalculator.com/health/6-minute-walk-testIntro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] ● Music provided by Audio Library Plus ● Watch: https://youtu.be/aBGk6aJM3IU ● Free Download / Stream: https://alplus.io/halfway-through TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are going to do an up-to-date review of the diagnosis and initial assessment of COPD in adults according to the NICE guideline [NG115], always focusing on what is relevant in Primary Care only. I will be creating further episodes on the management of stable COPD and COPD exacerbations so stay tuned. Right, so let’s jump into it.The diagnosis of COPD is suspected on the basis of symptoms and signs and is confirmed by spirometry.So, we should suspect COPD in people over 35 who have a risk factor (generally smoking or a history of smoking) and who present with 1 or more of the following symptoms:· exertional SOB· chronic cough · regular sputum · wheezing and · frequent so-called winter 'bronchitis'As part of our assessment, we will also check for signs such as:· weight loss· reduced exercise tolerance and fatigue· waking at night with breathlessness and· ankle swellingChest pain and haemoptysis, are uncommon symptoms in COPD and they should raise the possibility of alternative diagnoses. The Medical Research Council or MRC dyspnoea scale should be used to grade the breathlessness, so let’s have a look at it:· Grade 1 is when the patient is not troubled by breathlessness except on strenuous exercise· Grade 2 is when the patient develops shortness of breath when hurrying or walking up a slight hill· Grade 3 is when the patient walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace· Grade 4 is when the patient stops for breath after walking about 100 metres or after a few minutes on level ground and · Grade 5 is when the patient is too breathless to leave the house, or breathless when dressing or undressingOnce we have suspected COPD, we should confirm it with spirometry. So, spirometry should definitely be done:· At diagnosis; but it can also be ...
