Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a serious medical condition and is the 10th leading cause of death in Singapore.1The most important cause of COPD is cigarette smoking. Thus, not smoking cigarettes is the best way to prevent COPD and quitting smoking is the best way to stop the progression of this disease.
Management of COPD in National University Hospital
NUH's COPD programme is targeted towards preventing acute attacks of COPD, prolonging the survival and improving the symptoms and quality of life for our patients. We achieve this by taking on several approaches, including medications, smoking cessation therapy, education/counselling by experienced COPD Case Managers (nurse clinicians) and pulmonary rehabilitation.
In collaboration with our colleagues in the Emergency Medicine Department (EMD), we have also designed a comprehensive management programme for acute attacks of COPD. Severely ill patients who do not respond promptly to medical treatment will receive noninvasive ventilation (NIV) in the EMD itself to avoid the complications of tracheal intubation and prolonged ICU stays. Less ill patients will be assessed and treated in our EMD's Extended Diagnostic Treatment Unit (EDTU). If they are better, they may go home directly from the EMD.
As a chronic illness like COPD is often best managed at home, we have also introduced a Hospital At Home Programme in which an experienced Home Visit Nurse will perform a home visit and help patients and families cope more effectively with acute attacks. This is often undertaken as a continuation of EDTU treatment to ensure that our patients recover smoothly from an acute attack. For patients who are persistently symptomatic from advanced COPD we have embarked on an advanced care programme to optimise quality of life and symptom control either at home or in a hospice setting with palliative care physicians.
Noninvasive Ventilation for acute COPD in NUH
In noninvasive ventilation (NIV), a face mask is applied onto a patient and used to move air in and out of his/her lungs. The main aims of NIV are to reduce the need for intubation and mortality. NUH's NIV programme was rolled out in the Intensive Care Unit (ICU) in 2002. However, because it was likely that earlier administration of NIV could further improve outcomes, the NIV programme was extended to the Emergency Medicine Department (EMD) in 2003.
COPD Clinical Outcomes in National University Hospital
COPD is a major cause of hospitalisation and death internationally. NUH runs a comprehensive management programme which aims to improve the quality of life, reduce hospital admissions, and improve survival for patients with COPD. As per 2015 data, the average length of stay (ALOS) for a COPD patient is 3 days.
This material does not cover all information and is not intended as a substitute for professional care. Please consult your physician on any matters regarding your health.
- Ministry of Health Website, Singapore Health Facts: Principal Causes of Death, https://www.moh.gov.sg/content/moh_web/home/statistics/Health_Facts_Singapore/Principal_Causes_of_Death.html, accessed on 30 June 2016
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