investigation of exacerbation of COPD
Last reviewed 01/2018
Diagnosis of an exacerbation is usually made clinically. In patients who have their exacerbation managed in primary care:
- sending sputum samples for culture is not recommended in routine practice
- pulse oximetry is of value if there are clinical features of a severe exacerbation
In all patients with an exacerbation referred to hospital
- a chest radiograph should be obtained
- arterial blood gas tensions should be measured and the inspired oxygen concentration should be recorded
- an ECG should be recorded (to exclude comorbidities)
- a full blood count should be performed and urea and electrolyte concentrations should be measured
- if sputum is purulent, a sample should be sent for microscopy and culture
- blood cultures should be taken if the patient is pyrexial (1)
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