shortness of breath

Doctors Sara and Lisa discuss the podcast episodes over the year. We talk about our longer term learning points, how the year has gone and what's to come.
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback
Email us at: [email protected]
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Respiratory Physiotherapist Thomas James about COPD. We start with what COPD is, when to suspect it, a standard work up, pitfalls and points of consideration about spirometry, before moving on to an overview of management. We then cover some changes in the way COPD exacerbations are managed in South Manchester and the role of Eosinophils in both acute and chronic management. Understanding the role of Pulmonary rehabilitation, prednisolone and exercise in management are particular highlights. We cover our learning points from the episode at the end. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE COPD in adults (last updated Sept 2023): https://www.nice.org.uk/guidance/QS10
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Spirometry Guide: https://goldcopd.org/gold-spirometry-guide/
Association for Respiratory Technology and Physiology (ARTP) advice on Spirometry Interpretation: https://www.artp.org.uk/en/spirometry
Greater Manchester Medicines Management Group (GMMMG) COPD Management Plan Guideline (2021): https://gmmmg.nhs.uk/wp-content/uploads/2021/11/COPD-Treatment-Guideline-Nov-2021-V7.1.pdf
Greater Manchester Medicines Management Group (GMMMG) COPD Inhaler Guide (2021): https://gmmmg.nhs.uk/wp-content/uploads/2023/05/GMMMG-COPD-Inhaler-Guide-update-Mar-2023.pdf
Greater Manchester CURE Project for Smoking Cessation: https://gmcancer.org.uk/programmes-of-work/treatment/the-cure-project/
Greater Manchester Change, Grow, Live Services including Smoking Cessation: https://www.changegrowlive.org/
Primary Care Respiratory Society MRC Breathlessness scale: https://www.pcrs-uk.org/mrc-dyspnoea-scale
Our podcast with Dr Lesley Henson and Dr Caitriona MacDermott on Breathlessness in Palliative Care (May 2024): https://pckb.org/e/breathlessness-in-palliative-care/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback
Email us at: [email protected]
___
This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Palliative Care Consultant Lesley Henson and Specialty Doctor Dr Caitriona MacDermott about Breathlessness as a symptom in Palliative Patients. We start with a case to look at an approach to a patient with deteriorating breathlessness, before discussing a diagnosis of refractory breathlessness. We explore the importance of understanding the subjective nature of this experience before moving on to non-pharmacological and pharmacological options to help manage this often distressing symptom. We talk about managing anxiety around breathlessness and get their advice on discussions about death and managing these symptoms well. 
Useful resources: 
Greater Manchester Palliative Care Symptom Control Guidelines for Adults (2019 (p46, section on breathlessness): https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2020/01/Palliative-Care-Pain-and-Symptom-Control-Guidelines.pdf
Clinical Knowledge Summaries: Palliative Care - Dyspnoea (Updated Feb 2024): https://cks.nice.org.uk/topics/palliative-care-dyspnoea/#:~:text=Managing%20dyspnoea%20in%20palliative%20care,window%2C%20relaxation%20and%20breathing%20techniques.
MacMillan Resources: Managing Breathlessness, advice for Patients: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/breathlessness/managing-everyday-life-with-breathlessness?gad_source=1&gclid=cjwkcajwrckxbhbmeiwaivf8rhfcgjkvqpsq-is9gahloaxjoyq9tsfxwykwym08ewcsyoluupn-1xocq1sqavd_bwe&gclsrc=aw.ds
Cancer Research UK Resource for Patients and relatives around Breathing Problems for Patients with Cancer: https://www.cancerresearchuk.org/about-cancer/coping/physically/breathing-problems
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback
Email us at: [email protected]
_____
This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to talk to GP and Professor of General Practice Research Dr Carolyn Chew-Graham about the current landscape of Long COVID three years on. She spoke to us on the topic back in August 2021, but what we know and some of the treatments have moved on from then. In this talk we discuss why the patient-preferred term is Long COVID rather than Post COVID Syndrome, symptoms, how many people are living with the condition in the UK to date and some of the types of management and help that are available. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
Your COVID Recovery Website: https://www.yourcovidrecovery.nhs.uk/
Interviews with Patients with Long COVID: https://healthtalk.org/Long-Covid-In-Adults/overview
Postural Orthostatic Tachycardia Syndrome:
https://www.potsuk.org
 https://www.potsuk.org/gp_guide
BMJ Article on Orthostatic Tachycardia with Infographic Mentioned (March 2023): https://www.bmj.com/content/378/bmj-2022-072117
Information on Mastocytosis and Mast Cell Activation Syndrome:
https://ukmasto.org/#gsc.tab=0
https://www.potsuk.org/about-pots/associated-conditions/mcas/
Greater Manchester Long COVID Support Group: https://hsm.manchester.gov.uk/kb5/manchester/directory/service.page?id=Rn19N5XSimc
UK Long COVID Support Group: https://www.longcovid.org/
Support Groups for Families with a Child with Long COVID: https://www.longcovidkids.org/
Advice for Supporting a Child with Long COVID: https://theconversation.com/supporting-a-child-with-long-covid-tips-from-parents-of-children-living-with-the-condition-195153
Research on Impact of Long COVID on Racially Minoritised Groups: https://blog.westminster.ac.uk/hicovestudy/
Research on whether existing Medications have any Impact on Long COVID ‘STIMULATE ICP’: https://www.stimulate-icp.org/
LOCOMOTION Study looking at Optimising Treatments in Long COVID: https://bmjopen.bmj.com/content/12/5/e063505
Be Part of Research: What Trials are available (here for people with Long COVID): https://bepartofresearch.nihr.ac.uk/results/search-results?query=long%20covid&location=
National Institute for Health and Care Research: https://www.nihr.ac.uk/patients-carers-and-the-public/i-want-to-take-part-in-a-study.htm
Resources around advice for Returning to Work:
https://www.som.org.uk/take-planned-approach-managing-long-covid-workforce-new-som-guide
 https://www.fom.ac.uk/wp-content/uploads/longCOVID_guidance_04.pdf
 https://bjgp.org/content/71/712/508
NICE RCGP SIGN Guidance on Managing Patients with Long COVID (Last Updated Nov 2021): https://www.nice.org.uk/guidance/ng188
RCGP Online eLearning Module on Long COVID: https://elearning.rcgp.org.uk/course/view.php?id=492
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Drs Lisa and Sara are joined by GP Dr Nikesh Vallabh, Consultant Cardiologist Dr Karthikeyan and Consultant Gastroenterologist Dr Bliss to discuss advice and guidance.
For those unfamiliar, the advice and guidance system came about to try to ease pressure on the long outpatient waiting lists, providing a different way of managing some cases. It is in place for a number of specialties for primary care clinicians to ask questions to consultants, getting an answer that will help guide patient care within a matter of short weeks at most. We talk about the system and where it can fit in to make a difference to patient care. We take the opportunity to go through some common themes and glean learning points from these to help our own practice.
Useful resources: 
Wigan, Wrightington and Leigh have their own LFTs guideline that should be available on the intranet or contact the local CCG
BMJ LFTs Algorithm 2017: https://www.bsg.org.uk/wp-content/uploads/2019/12/Guidelines-on-the-management-of-abnormal-liver-blood-tests.pdf
Greater Manchester Guidelines for managing patients with dyspepsia in primary care: https://gpexcellencegm.org.uk/resources/guidelines-for-managing-patients-with-dyspepsia-in-primary-care/#.YFEP4C2l23U
NICE guidelines Chronic Heart Failure in Adults: Diagnosis and Management (2018) https://www.nice.org.uk/guidance/ng106
___
We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback
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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Originally recorded in January 2020 and released in August 2020...
Early diagnosis of cancer is a huge priority in order to try to improve our cancer survival rates in the UK. Lisa and Sara took the opportunity to speak to Dr Sarah Taylor, GP in Fallowfield and Cancer Research UK Cancer Diagnosis Lead for Greater Manchester about this important subject.
It was recorded pre-Covid-19 and so some of the information given about services might have changed in your local area. We thought the general tips about picking up cancer as early as possible were incredibly useful however which is why we decided to release the episode. 
We cover why early diagnosis of cancer is a priority for the UK, learning points/common themes picked up from significant events in delayed cancer diagnosis, tools that we can use in primary care to help our pick up rate and useful resources for primary care.
Useful resources: 
Gateway C: https://www.gatewayc.org.uk/
Cancer Research UK Health Professional Section: https://www.cancerresearchuk.org/health-professional
Macmillan Health Professional Resources: https://www.macmillan.org.uk/about-us/health-professionals/resources
QCancer Score: https://www.qcancer.org/
Cancer Research UK Facilitator Programme: https://www.cancerresearchuk.org/health-professional/learning-and-support/about-our-partnerships/what-is-the-facilitator-programme
NICE Suspected cancer - recognition and referral: https://www.nice.org.uk/guidance/ng12
BJGP - Improving early diagnosis of cancer in UK general practice: https://bjgp.org/content/67/659/276
___
We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to GP and Professor of General Practice Research Carolyn Chew Graham about Long COVID. We discuss what Long COVID is, its prevalence, and how to assess and manage those presenting with symptoms of possible Long COVID in primary care. We also talk about the condition in children, Long COVID clinics, and how to support patients on this still very new journey. Hopefully this episode will help support learning for the new Long-COVID enhanced service that has recently been launched by NHS England.
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NICE COVID-19 rapid guideline: managing the long-term effects of COVID-19 [NG188] Published: 18 December 2020: https://www.nice.org.uk/guidance/ng188
The Post-hospitalisation COVID-19 study (PHOSP-COVID): https://www.phosp.org/
British Thoracic Society Resources for the respiratory Community about COVID-19 (includes advice on chest x-rays and COVID): https://www.brit-thoracic.org.uk/covid-19/covid-19-information-for-the-respiratory-community/
Your COVID recovery resource: https://www.yourcovidrecovery.nhs.uk/app/
Long COVID SOS support group for patients: https://www.blf.org.uk/support-for-you/long-covid
UK Doctors with Long COVID Facebook Group: https://www.facebook.com/groups/479687042869493/
BJGP Open Article: Finding the 'right' GP: a qualitative study of the experiences of people with long-COVID 2020: 4(5) Kingstone T, Taylor AK, O'Donnell CA, Atherton H, Blane DN and Chew-Graham CA: https://bjgpopen.org/content/4/5/bjgpopen20X101143
Health Expectations Article: 'Reluctant pioneer': A qualitative study of doctors' experiences as patients with long COVID (Mar 2021) Taylor AK, Kingstone T, Briggs TA, O'Donnell CA, Atherton H, Blane DN, Chew-Graham CA: https://onlinelibrary.wiley.com/doi/10.1111/hex.13223
The Royal College of General Practitioners online learning module on Long COVID:https://elearning.rcgp.org.uk/course/view.php?id=492
Article, The Conversation: Aiyegbus OL, Haroon S, (July 2021) Long COVID: symptoms experienced during infection may predict lasting illness: https://theconversation.com/long-covid-symptoms-experienced-during-infection-may-predict-lasting-illness-164649?utm_source=twitter&utm_medium=bylinetwitterbutton
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We welcome any feedback you might have, our survey takes 1-2 minutes: pckb.org/feedback or contact us on Twitter @PCKBpodcast
___
This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Early diagnosis of cancer is a huge priority in order to try to improve our cancer survival rates in the UK. Lisa and Sara took the opportunity to speak to Dr Sarah Taylor, GP in Fallowfield and Cancer Research UK Cancer Diagnosis Lead for Greater Manchester about this important subject.
It was recorded pre-Covid-19 and so some of the information given about services might have changed in your local area. We thought the general tips about picking up cancer as early as possible were incredibly useful however which is why we decided to release the episode. 
We cover why early diagnosis of cancer is a priority for the UK, learning points/common themes picked up from significant events in delayed cancer diagnosis, tools that we can use in primary care to help our pick up rate and useful resources for primary care.
Useful resources: 
Gateway C: https://www.gatewayc.org.uk/
Cancer Research UK Health Professional Section: https://www.cancerresearchuk.org/health-professional
Macmillan Health Professional Resources: https://www.macmillan.org.uk/about-us/health-professionals/resources
QCancer Score: https://www.qcancer.org/
Cancer Research UK Facilitator Programme: https://www.cancerresearchuk.org/health-professional/learning-and-support/about-our-partnerships/what-is-the-facilitator-programme
NICE Suspected cancer - recognition and referral: https://www.nice.org.uk/guidance/ng12
BJGP - Improving early diagnosis of cancer in UK general practice: https://bjgp.org/content/67/659/276
___
We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Bronchiectasis can sometimes be overlooked amongst the other, more common lung conditions such as COPD. Because of this, it can be difficult for primary care clinicians to be fully aware of how to comprehensively diagnose and manage patients who have this condition. 
Lisa and Sara talk to respiratory consultant Dr Ashish about bronchiectasis. We learn exactly what this condition is, what the risk factors are for developing it, and when we should be suspicious of it as a cause. We also talk through important differentials to think about, what to look for on examination and which investigations to do (and the reliability of these). We finish by hearing about the role of sputum samples and what we can be doing in Primary Care to manage patients with bronchiectasis alongside Secondary Care.
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Useful resources: 
Table showing targeted antibiotic choices in bronchiectasis on NICE CKS: https://cks.nice.org.uk/bronchiectasis#!scenario:1 
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Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C
 ____
This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Interstitial lung disease (ILD) can be difficult to identify in primary care and unfortunately for some patients, currently carries a poor prognosis; the median survival for those with idiopathic pulmonary fibrosis is only 3–3.5 years (https://www.england.nhs.uk/wp-content/uploads/2018/08/Interstitial-lung-disease-service-adult.pdf).
Lisa and Sara talk to respiratory consultant Dr Ashish about this condition. We learn about when to be suspicious about a diagnosis of ILD, who is at risk and the symptoms and signs. We also hear about the reliability of the different investigations that are recommended in primary care and what happens after we have referred someone to outpatient respiratory clinic. We end with talking through how to manage exacerbations in these patients, prognosis and a little bit about fitness to fly.
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Useful resources: 
IPF Lung Sounds: https://www.insightsinipf.com/clinical-resources/auscultation/gallery/
GMMMG Shared Care Guidelines: http://gmmmg.nhs.uk/html/gmmmg_app_scgs.php
Fitness to Fly article from British Thoracic Society Standards of Care Committee: 'Managing passengers with respiratory disease planning air travel': https://thorax.bmj.com/content/57/4/289
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Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C
 ____
This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.