COPD Action Plans aim to help you recognise a flare up earlier and provide instructions on how to act to reduce the severity and duration of your illness.
To be successful it is essential that you plan it together with your doctor. Nursing and allied health staff can start the development of your plan however decisions about medicine changes must be made by a doctor or an appropriately qualified nurse practitioner.
COPD Action Plans work best when they are checked, updated and rehearsed regularly. This should occur each six months or after each flare up.
Talk to your doctor about developing a COPD action plan. When developing the plan with your doctor, you will discuss what happened with previous flare ups.
You will need to identify the lead up signs and symptoms you experienced (consider the events that were both associated and not associated with an infection), the treatment and outcomes.
Check your Symptom Diary for information.
You and your doctor will then agree on what actions you should take to manage your COPD whilst you are stable. When you are stable you are:
- Feeling your usual self.
- Taking your usual medicine.
- Have regular levels of energy.
- Sleeping normally.
- Not experiencing headaches or dizziness.
- Experiencing usual amounts of sputum.
Your stable section will include your “usual daily medicine” and may include other information about your care, i.e. contact details for your doctor, oxygen use and lung volume readings.
You and your doctor will also agree on treatment directions for management of a mild to moderate flare up.
A mild to moderate flare up is when you are feeling a little bit sick and are finding it harder to breathe.
When you are experiencing a mild to moderate flare up you may:
- Find it harder to breathe than usual.
- Have a fever. (Discuss with your doctor at what temperature a fever is, and how to best check this)
- Experience more coughing.
- Have more sputum or find it is thicker than usual.
- See a change of colour (or taste) in your sputum.
- Lose your appetite.
- Not be sleeping as well as normal.
- Not have much energy.
- Be taking more reliever medicine eg Ventolin.
This will include details about increasing your reliever dose, the frequency and the delivery method. You may also get directions on starting a course of steroid tablets and / or an antibiotic if signs of an infection are present.
You and your doctor will then agree on the point that you will need to seek urgent medical treatment in the case your flare up becomes severe.
During a severe flare up you may:
- Be very short of breath at rest.
- Have a high fever. (Discuss with your doctor at what temperature a high fever is, and how to best check this)
- Feel confused.
- Slur your speech.
- Feel drowsy.
- Experience chest pain.
- Feel afraid or scared.
- Notice blood in your sputum.
- Have difficulty sleeping or be woken easily in the night.
- Have swollen ankles (or your ankles are more swollen than usual).
It will be extremely important to recognise when to seek urgent treatment and what you can do whilst waiting for help to arrive. Your action plan will provide you with these instructions.
Your doctor will need to provide or arrange for prescriptions for extra medicines to use with the COPD Action Plan (e.g. steroid tablets or antibiotics to keep at home with your COPD Action Plan).
Don’t forget to get your doctor to sign and date the plan to ensure it is up to date.
Ask your doctor, nurse or health care person to regularly explain and reinforce the COPD Action Plan to you and to your carer including all the signs to watch for and actions to take.
Keep your plan somewhere visible at home (on the fridge). Remember to always bring your COPD Action Plan to your clinic, doctor appointments and admissions to hospital.
There are several versions of Action Plans for COPD and depending on where you live, a locally designed COPD Action Plan may be available. This is the Lung Foundation’s COPD Action Plan:
It doesn’t really matter which Action Plan you use. It is just important that you use one!