Assessment
The assessment of Indigenous people with a chronic lung condition should not significantly differ in content to the assessment of a non-indigenous person. The differences lie in the Cultural Awareness of the health professional, and the flexibility that may be required in practice to ensure appropriate provision of optimal healthcare services.
The diagnosis of a patient with bronchiectasis involves:
History of chronic cough
Production of phlegm
High resolution CT chest scan
The clinical assessment of a person diagnosed with bronchiectasis should generally include:
Measurement of oxygen saturation on pulse oximeter
Measurement of blood pressure and heart rate
Measurement of temperature
Auscultation, or listening to the lungs with a stethoscope
Cough and airway clearance
Mobility and exercise endurance
Bi-basal expansion – hands on assessment of the movement and pattern of lung expansion as the patient takes deep breaths
Venous or arterial blood gases
Pulmonary function tests
If an infection is suspected, the assessment may also include:
Blood tests
Chest X-rays or CT
Sputum (phlegm) samples
To assist with the assessment and diagnosis of patients in rural and remote areas, a digital stethescope and Bluetooth non-contact thermometer can be a valuable asset (Fig. 1).
With these devices, heart and lung sounds and body temperature can be recorded via an Apple or Android app on smartphones. These recordings can be saved for future comparison and /or uploaded to a cloud sharer to be viewed by a GP or physician for diagnosis and management.
