Acute COPD Flashcards
What is the most common infective cause of COPD exacerbations?
Haemophilus influenzae
Other bacteria include Streptococcus pneumoniae and Moraxella catarrhalis.
Which respiratory virus is a common cause of COPD exacerbations?
Human rhinovirus
What are the symptoms of COPD exacerbations?
- Increases dyspnoea
- Cough + wheeze
- Sputum (infective)
- Hypoxia + acute confusion
What is the initial AT HOME management for COPD exacerbations?
RESCUE PACK!
- Increases use of bronchodilator + nebuliser
- Prednisolone 30mg for 5 days
- Oral antibiotics if indicated with purulent sputum + signs of pneumonia
What oral antibiotics can be used for COPD exacerbations?
- Amoxicillin
- Clarithromycin
- Doxycycline
When should a patient be admitted to the hospital for COPD exacerbations?
- Severe SOB
- Acute confusion or altered consciousness
- Cyanosis
- O2 <90%
- Social reasons (e.g., cannot cope at home)
- Co-morbidity
What are the components of hospital care for COPD exacerbations?
- Oxygen
- Nebulised bronchodilator (Salbutamol or Ipatropium)
- Steroid therapy (IV hydrocortisone or oral prednisolone)
- IV theophylline (for patients not responding to nebulised bronchodilators)
- NIV (non-invasive ventilation) for patients with T2 RF
What does NIV stand for?
Non-invasive ventilation
When should BiBAP be considered in COPD patients?
When respiratory acidosis (PaCO2>6kPa, pH <7.35 ≥7.26) persists despite immediate maximum standard medical treatment
