COPD Secondary Survey

Question 1

COPD - Secodnary introduction

Answer 1

If there were no features of severe/life-threatening (see section 2), I would continue on to secondary.

If the patient was in too much distress I would begin my treatment (see section 2) and move on to the secondary survey where possible.

Help to rule out differential.

Question 2

COPD - HPC

Answer 2

o Trigger (infection, allergy, exertion)
o Cough
o Sputum
o Pain assoc with breathing (Pneumothorax differential)

Question 3

COPD - RMH

Answer 3

o	Diagnosis? 
o	Other respiratory issues
o	Surgeries
o	Smoker
o	Previous hospital admission 
o	Family history

Question 4

COPD - Meds

Answer 4

o Inhaler
• Reliever inhalers (blue) beta2-agonist (e.g. salbutamol), antimuscarinic inhalers (e.g. ipratropium)
• Preventer inhalers (brown, red or orange) corticosteroids (reduces inflammation)
• Nebuliser
o Oral Steroids – Powerful anti-inflammatory preventers (when other treatment fails)
o Other oral meds
o Personal asthma action plan
o O2
o CPAP/BiPAP

Question 5

COPD Inspection

Answer 5

o Hands/feet – colour, warmth, shape, oedema, clubbing
o Face – pursed lip breathing, cyanosis
o Resp rate, rhythm, depth, effort
o Thorax – recession, eq rise (pneumo differential) , chest shape (COPD?)

Question 6

COPD - Palpation

Answer 6

o Bony structures – differential for trauma
o Tracheal deviation – differential for pneumo
o Tactile fremitus – consolidation
o Respiratory excursion – (pneumo diff)

Question 7

COPD - Percussion

Answer 7

o Consolidation

o Asthma – hyper-resonance

Question 8

COPD - Ausculation

Answer 8

o Eq bi lat AE
o Wheeze
o Crackles – fluid/infection
o Bronchial and vesicular sounds where meant to be

Question 9

COPD - ECG

Answer 9

RULE OUT CARDIAC INVOLVEMENT