📄 ce, exposure avoidance (indoor/

ce, exposure avoidance (indoor/

ce, exposure avoidance (indoor/ outdoor pollution/allergens), and physical activity. Wherever available, all patients of COPD of all severities, must receive appropriate vaccination, including influenza (flu) vaccine, pneumococcal vaccine, Diphtheria-Pertussis-Tetanus vaccine and Covid-19 vaccine. For more information refer to the Medical Officer’s Manual for Prevention and Management of Chronic Obstructive Pulmonary Disease & Asthma. -- 93 of 136 -- 82 National Programme for Non-Communicable Diseases (NP-NCD) Training Module for Medical Officers RED FLAG SIGNS FOR PEOPLE HAVING EXACERBATION • Altered sensorium • spO2 110 bpm Heart rate >110 bpm • Systolic blood pressure <90 mmHg • High risk comorbid conditions (arrhythmia, congestive cardiac failure, poorly controlled diabetes, renal or liver failure) Refer to higher centre for further management, and ensure continued supplemental oxygen and nebulization during transfer. Admission criteria for COPD patients: 1. Severe symptoms; sudden worsening of resting dyspnea, 2. Fall in oxygen saturation, cyanosis, confusion, drowsiness. 3. Failure of an exacerbation to respond to initial medical management. 4. Presence of serious comorbidities (heart failure, newly occurring arrhythmias, etc.) 5.8 Management of Chronic Kidney Disease (CKD)37 Disease management for CKD include: • Lifestyle management includes abstaining from smoking and alcohol consumption and increased focus on weight reduction, dietary protein control, dietary salt restriction and increased physical activity. • Management of intra-renal factors associated with CKD like diabetes mellitus, hypertension, and vascular diseases. • Management of factors associated with progression of CKD like early diabetic nephropathy, obstructive neuropathy, glomerular disease, etc.…