NICE GUIDELINES
This short version of the guidelines has 12 pages, so don't even think about the full version, which has some 17 sections that go on forever.
All you really need is here, and much of it is really helpful, with a working definition and several charts so you can find your way through the diagnosis and management of stable and unstable COPD.
It is in a neat booklet as a PDF, so is easy to download and print off if you want a paper copy.
Why go there: the whole scene in 12 pages.
Downside: the best chart is split over two pages.
Information from: NICE
Address: www.nice.org.uk/nicemedia/pdf/CG012quickrefguide.pdf
PALLIATIVE CARE
This article, about patients with end-stage COPD in primary care, is written by a nurse, and very good it is too.
It is also written for nurses, so you might wonder why I recommend it. It is because it is good enough and detailed enough for any GP involved in end-stage care to learn from, and I wish I had some of this information when I looked after my last patient in this situation.
It can be frustrating when you want to give relief to someone who is gasping and working hard for every breath. It must be torture for the patient, and you feel desperate to offer them some respite.
There is no doubt reading this lengthy article will help satisfy your need to do something, and I suggest you give a copy to your district nurse as well.
Therapeutic and management tips on breathlessness, bronchodilator therapy, oxygen therapy, cough, anxiety - they are all here.
Why go there: doctor and patient can benefit.
Downside: none.
Information from: Journal of Community Nursing
Address: www.jcn.co.uk
ACUTE EXACERBATIONS
This garish page nearly puts you off, but stick with it.
This page helps you decide whether you can have a go at managing your patient with an acute exacerbation at home, or whether they need to go to hospital.
If you choose home care, then the link takes you to the key points of treatment and follow-up. It is in table form, so it is quick and easy to assimilate.
Why go there: a rapid reminder.
Downside: it looks horrible.
Information from: GP-training.net
Address: www.gp-training.net/protocol/respiratory/copd/copdhome.htm
COPD IN MY SOUP
I was naive enough to think that there wouldn't be many websites claiming to cure COPD, but I was wrong - there are nearly half a million of them.
I really was not sure if this one was a joke at first, but it is for real.
You are urged to buy two herbal soups, mystifyingly called Soup A and Soup B, that claim to regenerate damaged lung structure even in patients with severe COPD over 70 years of age.
The words ‘fly', ‘pigs' and ‘might' come instantly to mind.
And at $12.95 for just a sample, I dread to think what the recommended four months' treatment might cost the gullible.
Why go there: to laugh or cry - your choice.
Downside: no need to spell it out.
Information from: Wei Laboratories Inc.
Address: www.weilab.com/soup-copd.html
WEBSITE OF THE WEEK
You won't learn anything that will help you in the next two years on these pages, but you will find this website fascinating. It is cutting-edge stuff written by some eminent US chest physicians, and is an interesting glimpse into the future.
Lung volume reduction surgery sounds a bit weird - blocking up part of someone's lungs when they are already struggling to breathe. But this isolates the useless areas where air is trapped and gives better elastic recoil and respiratory mechanics to the lung tissue that is left.
Instead of lopping off bits of lobe someone has invented an endobronchial valve that plugs off individual bronchi leading to the worst affected areas.
Now you have got this far, go to the website and see some excellent images of the device and its insertion, and you can follow a link to a video of the procedure if you are so inclined.
Why go there: an antidote to a morning surgery of trivia.
Downside: won't help your next COPD patient.
Information from: Indiana University School of Medicine.
Address: www.iumg.iu.edu
Dr Barnard is a former GP in Fareham, Hampshire
