COPD DRABCDE

Question 1

Signs of COPD

Answer 1

o	Exertional breathlessness
o	Chronic cough
o	Regular sputum production
o	Frequent winter ‘bronchitis’
o	Wheeze
o	No clinical features of asthma

Question 2

Signs of COPD Exacerbation

Answer 2

o	>dyspnoea (esp on exertion)
o	Increased sputum 
o	Increased cough
o	Upper airway symptoms (e.g. cough and cold)
o	wheeze
o	Chest tightness
o	Fatigue
o	Acute confusion
o	Worsening of previous stable condition

Question 3

Signs of severe COPD Exacerbation

Answer 3

o	Marked dyspnoea
o	Tachypnoea
o	Purse lip breathing 
o	Accessory muscle use
o	Acute confusion
o	New onset cyanosis
o	New onset peripheral oedema
o	Marked reduction on activities of daily living

Question 4

Time critical features of COPD

Answer 4

o	Major abcd problems 
o	Extreme breathing difficulty 
o	Cyanosis (new onset)
o	Exhaustion
o	Hypoxia (

Question 5

COPD Differentials

Answer 5

o	Asthma
o	Pneumonia
o	Pneumothorax
o	LVF / Pulmonary Oedema
o	PE
Lung Ca
o	Upper airway obstruction 
o	Pleural effusion
o	Recurrent aspiration
NB – Chest pain and fever not often associated with COPD

Question 6

COPD - Response

Answer 6

o	Exhaustion (Life threatening)
o	ALOC (Life threatening)

Question 7

COPD - Airway

Answer 7

• Stridor or swelling may indicate anaphylaxis differential

* NB Bubbling or wheeze indicating respiratory distress

Question 8

COPD - Breathing

Answer 8

o	Marked dyspnoea
o	Tachypnoea
o	Purse lip breathing 
o	Accessory muscle use
o	Increased Respiratory effort 
o	Dyspnoea
o	Cyanosis 
o	Wheeze 
o	SpO2 ETCO2

Question 9

COPD - Circulation

Answer 9

o Tachycardia (>110/min = severe)

Question 10

COPD - Disability

Answer 10

o ALOC (Life threatening) ? cardio-respiratory arrest

Question 11

COPD - Expose

Answer 11

o Expose the chest to ensure no other causes for presentation