Respiratory - Chronic Airways Support Team (CAST)

Why have I been referred to CAST?

You have been referred to CAST as you are currently experiencing a worsening of your chest condition.

If you have been admitted to hospital, the medical team have carried out an assessment and have agreed that you can be discharged home under the care of CAST, who will monitor your condition at home. This is a safe alternative to you staying in hospital for a few extra days.

If you have not been in hospital, your GP or A&E doctor, has asked us to monitor your condition at home to reduce the need for you to be admitted to hospital.

What is CAST?

CAST is made up of healthcare professionals who are specialists in looking after people at home with respiratory conditions. The rapid response and district nursing teams can also provide advice and support out-of-hours.

What do CAST do?

A member of the team will carry out a thorough assessment of your chest on each visit to your home. CAST will continue to support you for up to 14 days.

Contact will be either a visit or a telephone call and the frequency of these will depend on your condition.

CAST will provide you with an individual treatment plan to manage your condition, both during your illness and in the future.
 
We may loan you a nebuliser (a machine that gives you medications similar to what is in your inhalers) for a few days and wean you back onto your usual inhaled therapy when you start to feel better.

Extra help

During your illness, you may feel more short of breath and find it more difficult to do everyday tasks. CAST can arrange short-term help for you to help your recovery by referring you to Rapid Response or a Social Worker.

What if I am not getting better?

If your condition is not improving in the way we would expect, we may request further assessment from your GP. We also meet weekly with the Specialist Respiratory Consultant where your care may be discussed.

If you require further assessments, tests or investigations, CAST will arrange this for you. In some circumstances, we may need to arrange for you to be admitted to hospital, but we would only do this when absolutely necessary.

Support Services

Sometimes we may suggest that you may benefit from input from other health professionals, such as dieticians, psychologists or pulmonary rehabilitation. CAST will refer you to these services when necessary and with your agreement.

Follow-up

It is important to review your condition when you are well, therefore you will be offered follow-up in one of the following ways:

1. By your practice nurse or GP
2. In a CAST clinic that will take place at your home
3. By a respiratory consultant.

On-going support following discharge from CAST

If your breathing gets worse you should refer to your COPD management plan. You may call 111 for out of hours GP or 999 for emergencies

If you become unwell again with your chest, CAST may be able to help you in the following ways:

1. Telephone advice
2. Home visits if required (although this may not be possible on the same day). If we are unable to see you at home you will be directed to the most appropriate team
3. Support on discharge from hospital if you are admitted (and the medical team agree).

We are here to help

CAST are dedicated to providing you with the best care for you and your family/carers, therefore if you require further advice or information, please do not hesitate to contact us on the following numbers.

Contact telephone numbers CAST

Monday to Sunday 9am – 5pm
Office – 0161 206 3165
Mobile – 0799 0523895

If your call is not urgent, you may leave a voice message on the office phone and someone will return your call.

Rapid Response

Monday to Sunday 5pm – 10pm – 0161 206 6666

Evening District Nursing Service

Monday to Sunday – 10pm – 7am – 0161 206 8921

What should I do if I get a sudden attack of breathlessness?

If your usual dose of reliever inhaler or nebulised reliever fails to bring relief in the usual way:

• Follow your management plan
• Try to keep calm as panicking will make your breathlessness worse
• Use extra doses of your reliever medication. Take 4 puffs of your blue inhaler via an aerochamber if you have one or use your nebuliser
• Try to take steady breaths in and out through your mouth to help get your breathing under control
• Use your oxygen if you have this at home, or any other medication you may have for your breathlessness. Do not increase your flow rate of oxygen or use above the recommended time as directed by the Home oxygen team

This plan may take 5 to 15 minutes to take effect.

If it does not work:

• Take a further 4-8 puffs of your blue inhaler or another dose of reliever through your nebuliser
• Send for help - you may call the numbers above or your GP, but if you can’t speak to someone directly or feel your condition is much worse, call 999 for an ambulance
• You may need to repeat the dose of your reliever inhaler or nebulised reliever while you are waiting for help.