Copd Treatment Guidelines

case study based on evidence in the management of acute exacerbations of COPD.

Introduction:

Chronic lung diseases have become increasingly one of the most common diseases chronic lung and a major cause of morbidity and mortality in the modern world. It is characterized by airflow limitation that is not fully reversible.

Chronic obstructive is a major cause of death worldwide (Calverley et al, 2003). The condition can cause loss of quality of work and quality of life can be significantly effected (Barnes, 1999). In the UK 27,478 men and women die because of chronic obstructive pulmonary disease and most deaths (90%) was at the age of 60 years (the British Thoracic Society. 2006).

Rehabilitation for patients with chronic lung disease is well established and widely accepted as a means of enhancing standard therapy in order to improve symptoms and maximize function patients (Siafakas et al, 1995; Ries, 1990; Casaburi, 1993 Fishman, 1996). In 1974, the American College of Chest Physicians (ACCP) is focused definition of pulmonary rehabilitation on three key elements and suggested that pulmonary rehabilitation is successful depends on three important elements, the individuality of each case 'multidisciplinary team approach and attention to the pathophysiology and psychopathology of each case.

A major problem with the COPD patient is the increase in lung secretions has led to increased shortness of breath. These two factors affect the function of the patient and the quality of life. For exacerbation, physical therapy is often needed to help clear secretions and reduce WOB, including non-invasive ventilation to avoid intubation (Alexander, 2001).

There are various techniques that can be used in physiotherapy to improve the patient's condition. Research suggests that postural drainage is beneficial in the chest from clearing secretions (Clarke, 1989; FALLING, 1986), respiratory muscle relaxation maneuver is effective in improving lung function in emphysema patients (Fujimoto et al, 1996) , relaxation can help reduce dyspnea and anxiety in chronic obstructive pulmonary disease (COPD) (Louie, 2004).

Case Description: (history, physical examination, and intervention)

The patient is a woman of 67 years with an acute exacerbation of chronic obstructive pulmonary disease (COPD). She complained of shortness of breath increased with a nonproductive cough. A febrile auscultation, rales bilateral rhonchus, and expiratory wheezing. Patient says she is on bronchodilators and steroids to low dose. Patient said she suffered from this problem for 10 years and has been on medication since. She does not exercise and his general practitioner who sees it usually never mentioned about seeing any physiotherapist. Recently, during this episode of acute exacerbation, she was informed by the doctor of the hospital to see a physiotherapist.

The strategy of this case study was used the model of problem solving, which includes six steps;

Step 1: patient assessment,

Step 2: problem definition,

Step 3: Determine the objectives,

Step 4: Identify appropriate techniques

Step 5: apply the techniques,

Step 6: reassessment of the situation of patients (Donna, 1987).

The assessment and evaluation:

Accurate assessment is the key player of physiotherapy and forms the basis for rational practice. A problem of evaluating image-based reasoning in pulmonary rehabilitation. As a result.