hospital or community setting for management of exacerbation of COPD

Last edited 12/2018 and last reviewed 08/2021

• factors which favour treatment in hospital
  
  
  • not able to cope at home
    
    
  • severe beathlessness
    
    
  • general condition is poor/ deteriorating
    
    
  • level of activity is poor/confined to bed
    
    
  • cyanosis is present
    
    
  • worsening peripheral oedema
    
    
  • impaired level of consciousness
    
    
  • patients is already receiving long term oxygen therapy
    
    
  • patient is living alone/ not coping
    
    
  • acute confusion is present
    
    
  • exacerbation has had a rapid rate of onset
    
    
  • there is significant comorbidity particularly cardiac disease and insulin-dependent diabetes)
    
    
  • SaO2 < 90%
    
    
  • changes on the chest radiograph are present
    
    
  • arterial pH level < 7.35
    
    
  • arterial PaO2 < 7 kPa

For further details the consult the full guideline (1).

Reference:

1. NICE (2018). Chronic obstructive pulmonary disease - management of chronic obstructive pulmonary disease in adults in primary care and secondary care