Exacerbations Flashcards
risk of readmission 30 days after exacerbation
22.6%
mortality rate within 1 year
20%
mortality rate within 5 years
50%
dynamic hyperinflation
-worse emphesema
-no elastic recoil
COPD exacerbation presentation
-acute onset less than 2 weeks
-worse in cold weather
greast risk factor for COPD exacerbation
-previous COPD exacerbation
-worse SOB
-reduced lung function
COPD exacerbation etiology
-70% because of virus or bactera
Purulent sputum
indicated bacterial cause of COPD exacerbation
COPD exacerbation symptoms
-increase in:
-SOB
-Sputum production
-sputum purulence
COPD exacerbation differential diagnosis
-HF
-pneumonia
-pleural effusion
-pulmonary embolism
-cardiac arrhythmia
COPD exacerbation frequency
1-2 times a year
treatment of mild COPD exacerbation
-SABA
treatment of moderate COPD exacerbation
-SABA
-oral corticosteroid(improve lung function, should not exceed 40 mg for 5 days) and/or antibiotic (5-7 days) for purulence
treatment of severe COPD exacerbation
-SABA
-oral corticosteriod +/- antibiotic
-inpatient/ED care
side effects of prednisone
-difficulty sleeping
-stomach upset
Target oxygen level in COPD
88-92%
biPAP
-non invasive mechanical ventilation
-delivers inspiratory and expiratory airway pressure
Invasive mechanical ventolation
-very serious
-sedation
-higher risk of mortality
severe asthma symptoms
-breathlessness, gitation
-sits hunched over
-RR>30
SPO3<90%
O2 levels for those with asthma
93-95% for adults
-94-98% for children
Albuterol in emergency
4-10 puffs MDI + spacer ever 20 min for 1 hour
why use albuterol and ipratropium?
helps improve FEV1 in really bad obstructions
oral steroids for asthma
-administer ASAP
-5-7 days for adults
-3-5 days for kids
-longer uses requires tapering
MgSO4
-2 g IV for 20 min
-improves bronchodilation
Heliox
60-80% helium with Oz
-reduce turbulence of gas flow
