acute COPD Flashcards
FEV1/FVC of COPD
<0.7
symptoms of COPD exacerbation
increasing cough and sputum reduced exercise tolerance clammy sweaty fever mental status change
signs of COPD exacerbation
tachypnoea low O2 sats use of acessory muscles cyanosis wheeze pale tachycardia hypotensive
in hospital mortality score for COPD
DECAF score
chest auscultation - COPD
decreased breath sounds
expiratory wheeze
coarse crackles
hyper resonant (secondary pneumothorax)
CXR findings of COPD
HYPERINFLATION
CONSOLIDATION
PNEUMOTHORAX
bloods for COPD
FBC U+E calcium CRP blood and sputum cultures if sepsis suspected
ECG findings COPD
cor pulmonale - enlargement of RH
immediate management of COPD
bronchodilators
corticosteoids
antibiotics (if evidence of infection)
oxygen therapy
brochodilators for COPD
salbutamol 5mg w 6-7L/min O2 repeat as required
supplemental O2 with nasal canula
ipratropium bromide 500micrograms nebulised with oxygen as above 4-6hrly
corticosteroid in COPD
hydrocortisone 100mg IV or pred 30mg orally
referrals for COPD
discuss senior member contact critical care outreach team referral to repsiratory team referral to physiotherapy team consider ICU
when ICU in COPD
Failure to repsond to medical management
patient requires ventilatory support to encompass both NIV and invasive ventilation
patient requries BP support
deterioration of blood gas following medical management
changes in mental status
further management of COPD
STOP smoking advice
respiratory rehabilitation
