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Welcome to Respiratory Health

Respiratory Health (RS)

  • Respiratory conditions are among the most frequent presentations in general practice(1), ranging from acute infections and asthma to chronic diseases such as COPD and interstitial lung disease. GPs play a central role in early diagnosis, ongoing management, and prevention of respiratory illness, often acting as the first point of contact for both acute and long-term care. This includes not only clinical assessment and treatment but also patient education, smoking cessation support, vaccination, and coordination of care with respiratory specialists. With increasing prevalence of chronic respiratory conditions and the impact of environmental and lifestyle factors, GPs must remain up to date with current guidelines and best practices. This chapter outlines the key knowledge, skills, and attitudes required to deliver safe, effective, and patient-centred respiratory care in the Irish primary care setting. 

    • RS1) Diagnose, manage, and prevent a wide range of respiratory conditions, including both acute and chronic presentations in patients of all ages.
    • RS2) Perform appropriate focused clinical examination of the respiratory system.
    • RS3) Perform and interpret respiratory diagnostic tests and procedures accurately, such as peak expiratory flow and pulse oximetry.
    • RS4) Identify appropriate indications for Chest X-ray, CT Chest, and Spirometry in primary care, ensuring timely investigation and referral.
    • RS5) Demonstrate and educate on the correct use of inhalers, spacer devices, and nebulisers.
    • RS6) Understand the interrelationship between respiratory diseases and other comorbidities.
    • RS7) Provide patient education and support for self-management of respiratory conditions.
    • RS8) Adopt a holistic approach to respiratory care, considering quality of life and social context.
    • RS9) Promote preventive care including vaccination, smoking cessation, and access to support groups.
    • RS10) Manage respiratory conditions through coordinated care and multidisciplinary collaboration.
    • RS11) Appreciate the role of the Chronic Disease Management Programme for COPD and Asthma.
    • RS12) Understand the role of Ambulatory Care Hubs in supporting GP respiratory management.
    • RS13) Identify, manage, and report infectious respiratory diseases per public health guidelines.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • The natural history of the condition, including whether acute or chronic
    • The incidence and prevalence, including in different demographic groups
    • Typical and atypical presentations
    • Recognition of normal variations throughout life
    • Risk factors, including lifestyle, socio-economic and genetic factors
    • Diagnostic features and differential diagnosis
    • Recognition of ‘alarm’ or ‘red flag’ features
    • Appropriate and relevant investigations
    • Interpretation of test results
    • Management, including initial and continuing care, chronic disease monitoring and emergency care
    • Patient and carer information and education
    • Prognosis

    Signs, Symptoms & Presentations

    • Chest Pain
    • Clubbing
    • Collapse
    • Cough
    • Cyanosis
    • Dyspnoea
    • Fatigue
    • Fever
    • Haemoptysis
    • Hoarseness
    • Lymphadenopathy
    • Malaise
    • Nasal Flaring
    • Pleural Effusion
    • Tachypnoea
    • Weight Loss
    • Wheeze

    Common and Important Conditions

    • Asthma
    • Asthma/COPD Overlap
    • Bronchiectasis
    • Chronic Obstructive Pulmonary Disease
    • Connective Tissue Disease
    • Cough from non-respiratory causes (e.g. GORD, ACE inhibitors)
    • Cystic Fibrosis
    • Interstitial Lung Disease
    • Pneumonia
    • Pneumothorax
    • Pulmonary Embolism
    • Respiratory Failure
    • Respiratory Malignancy
    • Respiratory Tract Infection (upper and lower)
    • Sarcoidosis
    • Sinusitis
    • Sleep Apnoea
    • Tuberculosis
    • Upper Respiratory Tract Malignancies

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed Learning

    Blended Learning Resources (Education Platform)

    COPD in General Practice

    Adult Asthma in General Practice

    Useful Websites

    Asthma Society of Ireland 

    GINA Guidelines

    GOLD Guidelines

    COPD Ireland

    Antibioticprescribing

    NCCP National Lung Cancer Referral Guideline

    Workplace Based Learning

    Workplace-based learning in respiratory health is greatly enhanced by taking the opportunity to engage with both general and specialised clinics during your hospital rotations. Whenever possible, attend dedicated services such as bronchoscopy, asthma, or COPD clinics to observe the investigation and management of more complex or chronic respiratory conditions. While access to services may vary across hospitals, most rotations will expose you to patients with acute exacerbations of asthma, COPD, or pneumonia; offering valuable insights into acute care, oxygen therapy, and discharge planning. These experiences build a strong foundation in recognising and responding to respiratory distress, interpreting key investigations like chest imaging and spirometry, and understanding when specialist input is needed. Actively seeking out these learning opportunities helps bridge the gap between hospital and community care, preparing you to confidently manage respiratory presentations across all stages of illness in general practice. Once practicing as a GP registrar, trainees will have the opportunity to manage respiratory conditions in the community, building on the knowledge acquired during hospital rotations.

    Day Release

    Day release sessions offer an excellent opportunity to deepen your understanding of respiratory health through interactive, case-based learning. These sessions allow trainees to discuss common respiratory presentations - such as cough, breathlessness, and wheeze - and to explore the management of chronic conditions like asthma and COPD in a supportive, peer-led environment. Reviewing spirometry results, practicing inhaler techniques, and discussing national guidelines help reinforce practical skills and evidence-based care. Group discussions also provide a chance to reflect on challenging cases, share experiences from different practices, and stay up to date with emerging treatments and referral pathways.

    Registrar Tutorials

    Registrar tutorials provide a focused and personalised setting to develop knowledge and skills in respiratory health. These sessions are ideal for working through real cases from your practice, such as managing asthma control, interpreting spirometry, or deciding when to refer for suspected lung cancer. With your trainer, you can explore the application of current guidelines, review inhaler techniques, and discuss patient-centred approaches to smoking cessation and chronic disease management. Tutorials also offer a safe space to reflect on clinical uncertainty, communication challenges, and the broader impact of respiratory illness on patients’ lives.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 10: Manage the care of adults, including older people with chronic conditions and complex multimorbidity

    For EPA 10, managing a patient with moderate asthma within the Chronic Disease Management Programme demonstrates structured long-term care, including use of recall systems, spirometry interpretation, and coordination with practice nurses and respiratory specialists. Reflection could cover strategies to improve adherence, address comorbidities, and optimise quality of life.

    Core Knowledge Test (CKT)

    • Management of acute/ chronic asthma.
    • Assessment of chronic cough.
    • Interpretation of Pulmonary Function Tests. 

    Clinical Competency Test (CCT)

    • A young male patient presenting for Chronic Disease Management of their Asthma.
    • A patient presenting with haemoptysis.
    • A patient presenting with new onset wheeze over the last 3 weeks.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.

  • 1.    Shah M, Fleming A, Barbosa TM, van der Velden AW, Parveen S, Vellinga A. Point prevalence audit surveys of respiratory tract infection consultations and antibiotic prescribing in primary care before and during the COVID-19 pandemic in Ireland. Journal of Antimicrobial Chemotherapy. 2023 May 3;78(5):1270–7.