Acute exacerbation of COPD

Question 1

What is the presentation of acute exacerbation of COPD?

Answer 1

• Increasing cough
• Reduced exercise tolerance
• tachypnoea
• Cyanosis
• wheeze
• Accessory muscles of breathing
• productive cough -sputum yellow
• fever if infective

Question 2

What are the classification of exacerbation of COPD?

Answer 2

*Infective and non-infective

Question 3

What are the crucial investigations needed in COPD?

Answer 3

• ABG!
• CXR to check for consolidation
• Blood and sputum cultures if sepsis suspected
• ECG may show evidence of cor pulmonale

Question 4

What is the management of acute exacerbation of COPD?

Answer 4

1. A-E assessment
2. ABG to check if CO2 retainer
3. O2 therapy titrated to target sats (88-92%)
4. Salbutamol 5mg Neb
5. Hydrocortisone 200mg IV or prednisolone 40mg PO
6. Ipratropium 500mcg neb
7. Antibiotics if evidence of infection
8. Consider NIV if type 2 resp failure