COPD - Treament & Management

Question 1

COPD - Time critical features

Answer 1

o	Major ABCD issues
o	Extreme breathing difficulty (compared to usual) 
o	Cyanosis (compared to normal)
o	Exhaustion 
o	Hypoxia (compared to normal (

Question 2

COPD - If time critical features:

Answer 2

1. Start correcting A&B problems
2. Undertake time critical transfer to nearest A&E
3. Continue patient management en-route
4. Providing pre-alert

Question 3

COPD - Routine treatment plan

Answer 3

1. Ask if individualised treatment plan and follow if applicable (pt often able to guide own treatment)
2. Assess if COPD exacerbation
3. Assess & Maintain airway patency
4. Assess Breathing (rate and effort)
5. Administer salbutamol (5mg in 6-8L/minO2) – relax muscles in small-medium airways
6. If inadequate administer Salbutamol concurrently with Ipratropium bromide (500mcg in 6-8mlL/min O2) (Limit nebulisation to 6 mins – consider concurrent from beginning)
7. Measure oxygen saturation and administer O2 if req – target range = 88-92% (caution hypoxic drive)
8. Undertake 12-lead ECG

Are they maintaining sats off of O2?

Consider alternative care pathway where appropriate

Question 4

COPD - If not responding to treatment:

Answer 4

o Consider non-invasive ventilation
o Rapid transfer to nearest receiving hospital
o Provide pre-alert
o Continue management en-route