copd and respiratory failure Flashcards
what to give in acute breathlessness in COPD
Steroids Nebulised bronchodilators Oxygen and target sats prescription VTE prophylaxis Antibiotics Sputum culture
COPD exacerbation types
Infective or non-infective
COPD exacerbation infection symptoms
Increased SOB
Increased sputum volume
Increased sputum purulence
What other symptoms can you have with COPD exacerbations
Wheeze/cough
Ankle oedema
Confusion/drowsiness
Investigations to do in copd exacerbation
CXR
ABG (don’t need to do if sats more than >94% on air and if they’re not drowsy or confused)
ECG
FBC
Sputum MC&C
Blood cultures (only do if they’re pyrexial)
Initial management of copd exacerbation
Bronchodilator use (SABA via spacer if well enough otherwise give via nebuliser air driven)
Prednisolone 30mg daily for 7 days
When to use abx
If have 2 or more of
Increased sputum volume
Colour change
Increasing breathlessness
When to give Abx for CAP or copd exacerbations
Don’t treat copd exacerbations with CAP protocols unless there is consolidation on CXR
How to choose pharmacological management
First use their FEV1FVC ratio and then use their mMRC score (A are those with mild COPD symptoms and D is the worst) to figure out a pharmacological management.
What count is responsive to steroids
High eosinophil count
What other comborbidities do those with COPD have
IHD Mental health Osteoporosis Bronchiectasis/astham Low BMI
When is long term oxygen therapy used
HOw often
pO2<7.3
Po2>7.3 <8 plus polycythaemia or cor pulmonale
Use at least 15h / day
Other oxygen therapies
Ambulatory oxygen (when walking around0 Short burst (as required)
Surgical COPD treatment for advanced
One way valve to allow air back out and collapse down
Surgical lung volume resection
Lung transplant
what is acute hypercapnia respiratory failure
-Presentstion?
Medical emergency
-AKA type 2 resp failure
-Problem is with ventilation therefore PaO2<8 and paCo2 >6
