Reflection Physiotherapy

This reflection on COPD patient scenario highlights the importance of following guidelines for assessment of care patients and judicious use of oxygen therapy in acute exacerbation of COPD. The author shares their experience of managing care for a COPD patient and how it influenced their practice. The article also discusses the impact of cigarette smoking on airway inflammation in asthma and COPD.

0Running head: REFLECTION PHYSIOTHERAPY
Reflection physiotherapy
Name of the student:
Name of the University:
Author’s note

1REFLECTION PHYSIOTHERAPY
Reflection on COPD patient scenario:
What I did?
A male patient between his mid 30s and 40s was approaching the house and he was on
supplemental oxygen. He had history of very heavy smoking and the symptoms revealed he had
an exacerbation of COP symptoms. My role was to treat COPD exacerbations in patient and
asthma was found as the main reason for it. My approach was to provide Salbutamol medication
to patient. The main rational for providing Salbutamol was that it is a bronchodilator that can
relax muscles of the airway and reduce bronchospasm in patients with COPD (Jenkins et al.,
2015). The eventual result was that the patient recovered soon and medication worked for him.
What did I learn?
From the experience of managing care for patients with COPD exacerbation, I learnt that
following the guideline for assessment of care patients helped me systematically conduct
assessment and determine best treatment for patient. The guideline supported me to review
patient history and assess the reason for emphysema. By this approach, I could find link between
emphysema and patient history. Cigarette smoking was found to be a major factor for
emphysema in COPD patient. Tamimi, Serdarevic & Hanania, (2012) explains that cigarette
smoking has adverse impact on airway inflammation in asthma and COPD. Asthma and COPD
is characterized by airway limitation. However, the role of cigarette smoking in COPD
exacerbation is that it accelerates lung function decline and deteriorate symptoms of patient.
Cigarette smoking also increases the chance of death by altering the inflammatory mechanism in
asthma (Bhatt et al., 2018). From this perspective, the assessment of patient in accordance with
guideline helped to identify the cause of exacerbation and determine appropriate treatment for it.

2REFLECTION PHYSIOTHERAPY
Despite taking the right approach to manage COPD exacerbation, I also did some mistake
while providing oxygen to patient. This was because the target should be 90 plus however I
provide oxygen at 9 litres per minute. It was wrong choice because above 80 value increases
pulse rate of patient. I gave the patient Hudson mask. However, after identifying my mistake,
learned that providing low flow oxygen at three litres per minute would have given better
experience to patient. According to current guidelines, SaO2 at 88-92 should be targeted for
COPD patient compared to 94-98% for patients with other chronic illness. Brill and Wedzicha
(2014) support that fact that supplemental oxygen at moderate concentration can overcome
hypoxia in patients with COPD exacerbation. Hence, the experience helped me to learn about the
judicious use of oxygen therapy in acute exacerbation of COPD.
How did this activity affirm or influence your practice?
The activity of managing acute COPD exacerbation influenced my practice as it helped to
learn about special requirements while considering use of oxygen therapy for such patient. I aim
to learn more about the effect of oxygen therapy at acute COPD exacerbation and understand the
method by which I can decreases the risk of unjudicious utilization of oxygen therapy in similar
situations in the future.

3REFLECTION PHYSIOTHERAPY
References:
Bhatt, S. P., Anderson, J. A., Brook, R. D., Calverley, P. M., Celli, B. R., Cowans, N. J., ... &
Yates, J. C. (2018). Cigarette smoking and response to inhaled corticosteroids in
COPD. European Respiratory Journal, 51(1), 1701393.
Brill, S. E., & Wedzicha, J. A. (2014). Oxygen therapy in acute exacerbations of chronic
obstructive pulmonary disease. International journal of chronic obstructive pulmonary
disease, 9, 1241.
Jenkins, C. R., Postma, D. S., Anzueto, A. R., Make, B. J., Peterson, S., Eriksson, G., &
Calverley, P. M. (2015). Reliever salbutamol use as a measure of exacerbation risk in
chronic obstructive pulmonary disease. BMC pulmonary medicine, 15(1), 97.
Tamimi, A., Serdarevic, D., & Hanania, N. A. (2012). The effects of cigarette smoke on airway
inflammation in asthma and COPD: therapeutic implications. Respiratory
medicine, 106(3), 319-328.