DEBBIE KENNEDY, SPECIALIST ASPERGILLOSIS NURSE NATIONAL ASPERGILLOSIS CENTRE UHSM MANCHESTER Support Meeting for Aspergill...
 
A Clinic Visit 4 th  November 2010 Patient Support Meeting ERC by  Debbie Kennedy Aspergillosis Specialist Nurse
Your Clinic Visit <ul><li>Where   </li></ul><ul><li>National Aspergillosis Centre based in the North West Lung Centre at U...
Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Welcomed </li></ul><ul><li>Weight </li></ul><ul><li>MRC Dyspnoea...
Vignette with  Georgina and Marie  Aspergillosis Specialist Nurses
MRC Breathlessness Scale
History – Past & Recent Who gets Aspergillosis   Inhalation of aspergillus spores is a common daily occurrence.  A healthy...
History  <ul><li>Signs and Symptoms </li></ul><ul><li>Weight loss  16 / 18 (89%) </li></ul><ul><li>Cough  15 / 18 (83%) </...
Chest Examination
Vignette with  Georgina and Marie  Aspergillosis Specialist Nurses
Chest X-ray
Chest Xray Aspergilloma Fungal Ball
Chest CT scan Fungal Ball
Lung Function Studies
Lung Function Studies
Bronchoscopy
Vignette with  Georgina and Marie  Aspergillosis Specialist Nurses
Specialist Aspergillus Tests <ul><li>Sputum test </li></ul><ul><li>Fungal Culture and Sensitivity </li></ul><ul><li>Sputum...
Sputum Fungal Culture
Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Blood tests </li></ul><ul><ul><li>Liver Function test </li></ul>...
Vignette with  Georgina and Marie  Aspergillosis Specialist Nurses
Specialist Aspergillus Tests <ul><li>Blood test </li></ul><ul><li>Aspergillus precipitins (IgG) and titre  </li></ul><ul><...
Information <ul><li>Contact Information </li></ul><ul><li>Information Leaflets </li></ul><ul><li>Website Information  </li...
Vignette with  Georgina and Marie  Aspergillosis Specialist Nurses
How to avoid Aspergillus <ul><li>Pulmonary infections can be prevented by  </li></ul><ul><ul><li>Avoid smoking </li></ul><...
Where is Aspergillosis <ul><li>Sources of Infection? </li></ul><ul><li>Aspergillus species are found in: </li></ul><ul><ul...
www.aspergillus.org.uk
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A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a

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A clinic visit by debbie kennedy to patient support group 5th novemebr 2010a

  1. 1. DEBBIE KENNEDY, SPECIALIST ASPERGILLOSIS NURSE NATIONAL ASPERGILLOSIS CENTRE UHSM MANCHESTER Support Meeting for Aspergillosis Patients Fungal Research Trust
  2. 3. A Clinic Visit 4 th November 2010 Patient Support Meeting ERC by Debbie Kennedy Aspergillosis Specialist Nurse
  3. 4. Your Clinic Visit <ul><li>Where </li></ul><ul><li>National Aspergillosis Centre based in the North West Lung Centre at University Hospital Manchester </li></ul><ul><li>When </li></ul><ul><li>Monday am Wednesday pm Friday am </li></ul><ul><li>Who </li></ul><ul><li>Foreground - Doctors, Specialist Nurses, Administration Manager, Physiotherapists, </li></ul><ul><li>Background - Specialist Laboratory staff, Researchers, Website Information Architect </li></ul><ul><li>Why </li></ul><ul><li>Nationally Commissioned Specialist Service to deliver all aspects of Aspergillosis Care </li></ul><ul><li>How </li></ul><ul><li>Face to face Multidisciplinary Team approach </li></ul><ul><li>Nurse driven telephone support service </li></ul>
  4. 5. Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Welcomed </li></ul><ul><li>Weight </li></ul><ul><li>MRC Dyspnoea (breathlessness) score </li></ul><ul><li>Quality of Life Questionnaire </li></ul><ul><li>History </li></ul><ul><li>Chest Examination </li></ul><ul><li>Chest X-ray </li></ul><ul><li>CT Scan </li></ul><ul><li>Lung Function Studies </li></ul><ul><li>Bronchoscopy </li></ul><ul><li>Specialist Aspergillus Tests </li></ul><ul><li>Information Giving </li></ul><ul><li>Avoidance </li></ul>
  5. 6. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  6. 7. MRC Breathlessness Scale
  7. 8. History – Past & Recent Who gets Aspergillosis Inhalation of aspergillus spores is a common daily occurrence. A healthy immune system would normally remove the spores and no symptoms or infection would occur. In individuals whose immune system may be suppressed either because of illness e.g. AIDS, cancer patients or drugs, spores may germinate and resulting tissue or systemic aspergillus invasion can result. Individuals with allergies such as asthma, can also be vulnerable to aspergillus disease.
  8. 9. History <ul><li>Signs and Symptoms </li></ul><ul><li>Weight loss 16 / 18 (89%) </li></ul><ul><li>Cough 15 / 18 (83%) </li></ul><ul><li>Shortness of breath 9 / 18 (50%) </li></ul><ul><li>Haemoptysis 9 / 18 (50%) </li></ul><ul><li>Fatigue / malaise 5 / 18 (28%) </li></ul><ul><li>Chest pain 3 / 18 (17%) </li></ul><ul><li>Sputum production ++ 3 / 18 (17%) </li></ul><ul><li>Fever 2 / 18 (11%) </li></ul>Denning DW et al, Clin Infect Dis 2003; 37:S265
  9. 10. Chest Examination
  10. 11. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  11. 12. Chest X-ray
  12. 13. Chest Xray Aspergilloma Fungal Ball
  13. 14. Chest CT scan Fungal Ball
  14. 15. Lung Function Studies
  15. 16. Lung Function Studies
  16. 17. Bronchoscopy
  17. 18. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  18. 19. Specialist Aspergillus Tests <ul><li>Sputum test </li></ul><ul><li>Fungal Culture and Sensitivity </li></ul><ul><li>Sputum PCR </li></ul>
  19. 20. Sputum Fungal Culture
  20. 21. Your Clinic Visit <ul><li>What Happens? </li></ul><ul><li>Blood tests </li></ul><ul><ul><li>Liver Function test </li></ul></ul><ul><ul><li>Kidney function test </li></ul></ul><ul><ul><li>Glucose </li></ul></ul><ul><ul><li>Full Blood Count – anaemia, infection </li></ul></ul><ul><ul><li>Immune system </li></ul></ul><ul><ul><li>Inflammatory markers </li></ul></ul><ul><ul><li>Allergy Levels </li></ul></ul><ul><ul><li>Drug Monitoring Levels </li></ul></ul><ul><ul><li>Vitamin D Levels </li></ul></ul><ul><ul><li>Research Bloods </li></ul></ul>
  21. 22. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  22. 23. Specialist Aspergillus Tests <ul><li>Blood test </li></ul><ul><li>Aspergillus precipitins (IgG) and titre </li></ul><ul><li>Total Immunoglobulin E (IgE) </li></ul><ul><li>Aspergillus specific IgE (RAST) </li></ul><ul><li>Drug Monitoring Levels </li></ul>
  23. 24. Information <ul><li>Contact Information </li></ul><ul><li>Information Leaflets </li></ul><ul><li>Website Information </li></ul><ul><li>Smoking Cessation </li></ul><ul><li>Physiotherapist Advice </li></ul><ul><li>Aspergillus Avoidance </li></ul>
  24. 25. Vignette with Georgina and Marie Aspergillosis Specialist Nurses
  25. 26. How to avoid Aspergillus <ul><li>Pulmonary infections can be prevented by </li></ul><ul><ul><li>Avoid smoking </li></ul></ul><ul><ul><li>Do not use bedside humidifiers </li></ul></ul><ul><li>Sources of Aspergillus spores </li></ul><ul><ul><li>animal stables </li></ul></ul><ul><ul><li>Hay </li></ul></ul><ul><ul><li>Mulch </li></ul></ul><ul><ul><li>rotten plants, </li></ul></ul><ul><ul><li>compost piles, </li></ul></ul><ul><ul><li>wood chips </li></ul></ul><ul><ul><li>construction sites </li></ul></ul>
  26. 27. Where is Aspergillosis <ul><li>Sources of Infection? </li></ul><ul><li>Aspergillus species are found in: </li></ul><ul><ul><li>Soil </li></ul></ul><ul><ul><li>Air; spores may be inhaled </li></ul></ul><ul><ul><li>Water / storage tanks in hospitals etc </li></ul></ul><ul><ul><li>Food </li></ul></ul><ul><ul><li>Compost and decaying vegetation </li></ul></ul><ul><ul><li>Fire proofing materials </li></ul></ul><ul><ul><li>Bedding, pillows </li></ul></ul><ul><ul><li>Ventilation and air conditioning systems </li></ul></ul><ul><ul><li>Computer fans </li></ul></ul>
  27. 28. www.aspergillus.org.uk
  28. 29. Thank you

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