Treating nasal symptoms in patients with refractory breathlessness
- Daly, Rachel
In this article…
Why nasal symptoms are often not properly managed in patients with complex breathlessness
How simple and tailored management advice can dramatically improve symptoms
How this also improves symptoms of other co-existing conditions, such as asthma
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This initiative won the Respiratory Nursing category in the 2021 Nursing Times Awards.
To find out more about the NT Awards go to awards.nursingtimes.net
Key points
Uncontrolled rhinitis is common in patients with complex breathlessness, who have conditions such as asthma, inducible laryngeal obstruction or breathing pattern disorder
Nasal symptoms are often overlooked as treatment focuses on breathlessness and adjusting asthma medication
In the Manchester Airways Service, we developed a new pathway to improve management of rhinitis in patients with complex breathlessness
Our audit showed improvements in both nasal symptoms and asthma control
We now plan to assess nasal nitric oxide testing as a non-invasive way of measuring inflammation in this group
Abstract
Patients attending the airways service for complex breathlessness at Manchester University NHS Foundation Trust, due to issues such as asthma, inducible laryngeal obstruction or breathing pattern disorder, also often have nasal symptoms. Attention is rarely paid to these; the focus is on asthma medication and breathlessness management. During the Covid-19 pandemic, we focused on a holistic ‘one airway’ approach to address symptoms and provide a tailored management plan for patients with co-occurring rhinitic symptoms, which included staff training on the proper technique for administering nasal sprays. Over a one-year period, our audit showed a dramatic improvement in nasal and asthma symptoms, and a reduced need for ear, nose and throat referrals. We plan to continue this approach and are reviewing it to ensure consistency across the trust.