COPD Exacerbation
This is often triggered by infection.
It presents with:
Acute worsening of symptoms such as dyspnoea
Productive cough w/change of colour
Wheeze
Differentials here include:
Asthma exacerbation
Pulmonary oedema
Pneumonia
PE
Anaphylaxis
Investigations
The main investigation to do is an ABG, which will show respiratory acidosis, raised CO2, and raised bicarbonate.
Other investigations to do include:
Bloods - FBC, U&E
CXR
ECG
Sputum and blood culture
Management
First things to be given to patients are:
O2 with aim of 88-92%
Nebulised bronchodilators e.g. salbutamol, ipratropium
Steroids e.g. oral prednisolone or IV hydrocortisone
Abx if evidence of infection
If no improvement:
Admit to ITU
IV Aminophylline
NIV/Intubation (If not appropriate, doxapram can be used as a respiratory stimulant)