COPD Flashcards
1
Q
What drugs and doses are administered in the COPD CPG?
A
- Salbutamol 10mg and Ipratropium Bromide 500mcg Neb
- Dexamethasone 8mg IV/Oral
2
Q
If you have an adequate response post drug admin in COPD what do you do?
A
- Titrate O2 flow to target SpO2 88-92%
- Consider low flow O2 - e.g. nasal prongs
3
Q
If you have an inadequate response to drug therapy in a COPD patient, what do you do?
A
- MICA can commence CPAP and assess for signs of deteriorating respiratory status or ventilation failure
4
Q
What do you do if despite treatment, the COPD patient deteriorates?
A
- Provide assisted ventilation with 100% FiO2, if inadequate tidal volume or RR
- MICA can consider ETT
5
Q
When should COPD be suspected?
A
Patient over 40 who has
- Smoking history
- Dyspnoea that is progressive, persistent and worse on exercise
- Chronic cough
- Chronic sputum production
- Family Hx of COPD
6
Q
How do you define Exacerbation of COPD
A
- increased dyspnoea
- increased cough
- increased sputum production
- complete removal of wheeze in these patients may not be possible due to chronic airway disease
7
Q
What are the indications for CPAP?
A
- SpO2 < 90% on RA
OR - SpO2 <95% on supplemental O2
8
Q
What are the indications for the removal of pre-hospital CPAP
A
Ineffective
- cardiac/respiratory arrest
- mask intolerance/patient agitation
- nil improvement after 1 hour of treatment
Vital signs
- HR < 50
- SBP < 90mmHg
- LOC or GCS <13
- decreasing SpO2
Active risk to patient
- loss of airway control
- copious secretions
- active vomiting
- paramedic judgement of clinical deterioration
