Adult COPD

Question 1

What history might make you suspect COPD

Answer 1

Any patient over 40 who has
-smoking history
- Dyspnoea that is progressive, persistent and worse with exercise
- Chronic cough
- Chronic sputum production
- Family history of COPD

Question 2

Exacerbation of COPD can be defined as

Answer 2

• Increased dyspnoea
• Increased cough
• Increased sputum production -
• Complete removal of wheeze may not be possible

Question 3

Non-invasive ventilation in the COPD patient notes

Answer 3

Patients with known COPD maybe be known as C02 retainers. if suspected NIV can be applied

Question 4

Differentials for COPD

Answer 4

• APO
• Asthma
• Anaphylaxis
• CCF

Question 5

Focused assessments

Answer 5

-RASH
-AEIOUTIPS (altered conscious state)

Question 6

COPD clinical deterioration risks

Answer 6

• Respiratory deterioraton
• Arrythmias
• Altered conscious state
• Shock

Question 7

Treatment plan for COPD

Answer 7

• Position
• Reassure
• 02 therapy
• Salbutamol 10mg (5ml)
• 500mcg Ipratropium bromide (2mls)
• 8 mg Dexamethasone oral / IV
• Titrate O2
• If No MICA CPAP start at 7.5cmH20 then to 10cmH20
  If not tolerated
  If required ventilate as required in 100 % O2