1(E): COPD Exacerbation Flashcards
What is a COPD exacerbation
Acute increase in symptoms of COPD
What time of year are COPD exacerbations more common
Winter
Are bacterial or viral causes of COPD exacerbation more common
Bacterial (80%)
What is the most common cause of COPD exacerbation
H. Influenza
What 3 bacteria cause infective exacerbation of COPD
H. Influenza
S. Pneumonia
Morexella catarrhalis
What viral infection causes infective exacerbation of COPD
Rhinovirus
What are symptoms of COPD
Dyspnoea
Productive cough
Wheeze
Hypoxia
What investigations are ordered in exacerbation of COPD
- Obs
- ABG
- CXR
- MC+S
What is first-line management for acute exacerbation of COPD
Nebulised salbutamol and ipratropium bromide
What is second-line for acute exacerbation of COPD
Oxygen
How is oxygen given in acute exacerbation of COPD
Venturi mask
What SpO2 is aimed for in acute exacerbation of COPD
88-92
What is third-line in acute exacerbation of COPD
Steroids: IV hydrocortisone and prednisone
What antibiotics are given in acute exacerbation of COPD
Amoxicillin
If an individual is penicillin allergic, what is second-line to amoxicillin
Clarithromycin or Doxycycline
If no response to management thus far in exacerbation-of COPD, what is given
Theophylline
What conservative measures are used in management of COPD
Physiotherapy - to aid mucus clearance
If no response to aminophylline, what is considered
Non-invasive positive pressure ventilation
What are indications for non-invasive ventilation
- RR >30
- pH <7.35
- Increasing pCO2
If patients are not suitable for mechanical ventilation, what is offered
Respiratory stimulant drug (IV Doxepram)
What are indications for intubation and ventilation
pH <7.26 or pCO2 rising despite optimal medical management
