 |
|||||
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
M
E
E
T
I
N
G
S
CASE
HISTORY
DYSPNOEA
IN PALLIATIVE CARE
Brian is a 57 year old smoker. He presented to his GP with recent onset breathlessness. A chest x-ray was ordered which was reported as a showing a right hilar tumour. He was referred to the BGH where he underwent bronchoscopy and biopsy. Histology revealed that he had a small cell carcinoma of his lung and he underwent a course of chemotherapy with resolution of his breathlessness. Brian remained asymptomatic for three months.
One Sunday Brian's wife phones BORDOC requesting a comode for him. The call is passed to the district nurse on duty.
Question 1
You are the district nurse on duty and take the comode to Brian. You find that he requires it because he has become too breathless to get to the toilet. What assessment would you make?
Question 2
You are very concerned about his breathlessness and phone BORDOC. The duty doctors says that he will visit but will be about 45 minutes. What could you do to help ease Brian's distress in the meantime?
Question 3.
You are the duty doctor for BORDOC and visit Brian at home. What are the possible causes of his deterioration and what features might you look for?
Question 4.
What is the clinical syndrome and what would be the likely management of this?
A few months later Brian's condition deteriorates once again but he is told that there is nothing further that can be done to treat the cancer. He wants to remain at home but becomes distressed by breathlessness at rest.
Question 5
What palliative measures could you take to make him more comfortable?
[Top
of Page] [Home]
[Search] [Network]
[Services]
[Newsletters] [Guidelines]
[Directory] [Meetings]
[Projects]
[Links] [Contact
Us] [Facilitators]