{"id":4382,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratorypalliativecare\/"},"modified":"2024-11-11T15:55:10","modified_gmt":"2024-11-11T15:55:10","slug":"respiratorypalliativecare","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/palliativecare\/respiratorypalliativecare\/","title":{"rendered":"Respiratory (Palliative Care)"},"content":{"rendered":"\n<title>Respiratory (Palliative Care)<\/title>\n\n\n\n<p><strong>Information<\/strong><\/p>\n\n\n\n<p>All patients with advanced progressive respiratory disease (including COPD, interstitial disease, bronchiectasis, respiratory failure and cancer) reach a stage of illness where comfort and symptom management become increasingly important and disease modifying treatment less important<\/p>\n\n\n\n<p>Palliative care can also contribute towards helping a patient adjust their treatment goals and make plans for anticipated deterioration<\/p>\n\n\n\n<p>This change in focus is often supported by primary care teams but may be enhanced by palliative care referral especially for patients with complex symptoms or other needs.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients in palliative phase of illness (the &#8220;surprise&#8221; question &#8211; would you be surprised if the patient died in the next 12 months?)<\/li>\n\n\n\n<li>Two or more of the following:\n<ul class=\"wp-block-list\">\n<li>Severe airways obstruction (FEV1 &lt; 30%) or restrictive<\/li>\n\n\n\n<li>Deficit (vital capacity &lt; 60%, transfer factor &lt; 40%)<\/li>\n\n\n\n<li>Meets criteria for long term oxygen therapy (PaO2 &lt; 7.3 kPa)<\/li>\n\n\n\n<li>Breathless at rest or on minimal exertion between exacerbations<\/li>\n\n\n\n<li>Persistent severe symptoms despite optimal tolerated therapy<\/li>\n\n\n\n<li>Symptomatic right heart failure<\/li>\n\n\n\n<li>Low body mass index (&lt; 21)<\/li>\n\n\n\n<li>More emergency admissions (&gt; 3) for infective exacerbations or respiratory failure in past year.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients whose disease is stable<\/li>\n\n\n\n<li>Patients where you would be surprised if they died in the next 12 months<\/li>\n\n\n\n<li>Patients who do not accept a palliative approach to their illness<\/li>\n\n\n\n<li>Patients who have expressed a wish to have no extra help.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>Referral details for the different Palliative Care services are available&nbsp;at&nbsp;<a href=\"https:\/\/services.nhslothian.scot\/palliativecare\/specialist-palliative-care-services-in-lothian\/\" data-type=\"URL\" data-id=\"https:\/\/services.nhslothian.scot\/palliativecare\/specialist-palliative-care-services-in-lothian\/\" target=\"_blank\" rel=\"noreferrer noopener\">Palliative Care &#8211; Specialist Palliative Care<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>Scottish palliative care guidelines on breathlessness<\/strong><\/p>\n\n\n\n<p><a href=\"https:\/\/www.palliativecareguidelines.scot.nhs.uk\/guidelines\/symptom-control\/breathlessness.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.palliativecareguidelines.scot.nhs.uk\/guidelines\/symptom-control\/breathlessness.aspx<\/a><\/p>\n\n\n\n<p><strong>Palliative care Kardex:<\/strong><\/p>\n\n\n\n<p><strong><a href=\"\/files\/sites\/2\/anticipatory-medication.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">anticipatory medication.pdf<\/a><\/strong><\/p>\n\n\n\n<p><strong>Hospital at home<\/strong><\/p>\n\n\n\n<p><a href=\"\/refhelp\/urgent-care\/hospital-at-home\" target=\"_blank\" rel=\"noreferrer noopener\">Hospital at Home (nhslothian.scot)<\/a><\/p>\n\n\n\n<p><strong>Community Respiratory Team<\/strong><\/p>\n\n\n\n<p><a href=\"\/refhelp\/Respiratory\/EdinburghCommunityRespiratoryTeam\" target=\"_blank\" rel=\"noreferrer noopener\">Edinburgh Community Respiratory Team (nhslothian.scot)<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/midlothiancommunityrespiratoryteam\/\" data-type=\"page\" data-id=\"4139\" target=\"_blank\" rel=\"noreferrer noopener\">Midlothian Community Respiratory Team (nhslothian.scot)<\/a><\/p>\n\n\n\n<p><strong>Home oxygen<\/strong><\/p>\n\n\n\n<p><a href=\"\/refhelp\/Respiratory\/OxygenTherapy\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/Respiratory\/OxygenTherapy<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"http:\/\/www.chss.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Chest, Heart and Stroke Scotland<\/a><\/li>\n\n\n\n<li><a href=\"http:\/\/www.lunguk.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">British Lung Foundation<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.vocal.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.vocal.org.uk\/<\/a><\/li>\n\n\n\n<li>SPICT. Future Care Planning REDMAP pocket guide <a href=\"https:\/\/www.spict.org.uk\/wp-content\/uploads\/2023\/10\/REDMAP-cards-for-staff-September-2023.pdf\">https:\/\/www.spict.org.uk\/wp-content\/uploads\/2023\/10\/REDMAP-cards-for-staff-September-2023.pdf<\/a><\/li>\n\n\n\n<li>Ihub. Future Care Planning Toolkit <a href=\"https:\/\/ihub.scot\/project-toolkits\/future-care-planning-toolkit\/future-care-planning-toolkit\/\">https:\/\/ihub.scot\/project-toolkits\/future-care-planning-toolkit\/future-care-planning-toolkit\/<\/a><\/li>\n\n\n\n<li>NHS Inform. Future Care Planning &#8211; <a href=\"https:\/\/www.nhsinform.scot\/care-support-and-rights\/decisions-about-care\/future-care-planning\/\">https:\/\/www.nhsinform.scot\/care-support-and-rights\/decisions-about-care\/future-care-planning\/<\/a><\/li>\n\n\n\n<li>TURAS Learn. Realistic Medicine &#8211; Having Realistic Conversations <a href=\"https:\/\/learn.nes.nhs.scot\/60442\">https:\/\/learn.nes.nhs.scot\/60442<\/a><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Respiratory (Palliative Care) Information All patients with advanced progressive respiratory disease (including COPD, interstitial disease, bronchiectasis, respiratory failure and cancer) reach a stage of illness where comfort and symptom management become increasingly important and disease modifying treatment less important Palliative care can also contribute towards helping a patient adjust their treatment goals and make plans<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4283,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[539],"class_list":["post-4382","page","type-page","status-publish","hentry","category-respiratorypalliativecare"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/palliativecare\/respiratorypalliativecare\/\" rel=\"tag\">Respiratory (Palliative Care)<\/a>","rttpg_excerpt":"Respiratory (Palliative Care) Information All patients with advanced progressive respiratory disease (including COPD, interstitial disease, bronchiectasis, respiratory failure and cancer) reach a stage of illness where comfort and symptom management become increasingly important and disease modifying treatment less important Palliative care can also contribute towards helping a patient adjust their treatment goals and make plans","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4382","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4382"}],"version-history":[{"count":5,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4382\/revisions"}],"predecessor-version":[{"id":21486,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4382\/revisions\/21486"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4283"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4382"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4382"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}