bjective assessment

1: Do you have severe chest pain?
Yes = see a doctor; No = go to 2

2: Do you cough up blood?
Yes = see a doctor; No = go to 3

3: Is the in-breath louder than the out-breath (stridor)?
Yes = see a doctor; No = go to 4

4: Is the patient out of breath when speaking? (note: do their shoulders move to help them breathe)
Yes = severe breathlessness; No = go to 5

5: Do you now struggle with a normal activity such as walking, which didn’t happen before?
Yes = ADL limited by breathlessness; No = go to 6

6: Time taken for sit to stand test?
Note time taken then go to 7

7: using Borg scale, patient points to the level that describes their breathlessness?
Note answer given then go to 8

8: can you hear crackles with your ear or stethoscope?
Yes = sputum needs clearance; No = go to 9

9: Can you feel the crackles with your hand?
Yes = sputum needs clearance; No = go to 10

10: Are the crackles high in the lungs?
Yes = go to 11; No = sputum needs clearance

11: Do you hear bronchial breathing or reduced breath sounds?
Yes = go to 12; No = reduced breath in lungs, go to doctor

12: Do you feel aches around your shoulders or chest from coughing and bringing up sputum?
Yes = needs pain relief; No = go to 13

13: Are you drinking enough water?
Yes = go to 14; No = de-hydrated

14: Do you (the patient) have a lot of sputum?
Yes = excess sputum; No = go to 15

15: Does the amount of sputum bother you?
Yes = Education in sputum clearance; No = go 16

16: Has your sputum changed colour or is it thicker?
Yes = go to 17; No = go to 19

17: Do you have bronchiectasis or COPD?
Yes = go to doctor; No = go to 18

18: Do you feel ill/ have a temperature?
Yes = consider going to doctor for potential infection; No = go to 19

19: Do you have problem with bringing up sputum?
Yes = go to 20; No = go to 23

20: Is the problem of bringing up sputum due to pain?
Yes = pain in sputum retention; No = go to 21

21: Is the problem of bringing up sputum due to weakness?
Yes = weakness causing sputum retention; No = go to 22

22: Is the problem of bringing up sputum due to a social reason or embarrassment?
Yes = embarrassment; No = go to 23

23: Does the problem of bringing up sputum cause other problems such as wetting yourself?
Yes = causes wetting; No = go to 24

24: Outcome measures (done after treatment): Is the sputum now clearer?
Yes = go to 25; No = repeat treatment

25: Outcome measures (done after treatment): Can the patient now manage their own secretions?
Yes = (finish); No = repeat treatment