hospital treatment in exacerbation of COPD
Last reviewed 01/2018
If hospital treatment is indicated then:
- investigations include:
- echest X-ray
- arterial blood gases (record inspired oxygen concentration)
- ECG
- blood tests
- Full blood count and urea and electrolytes
- Theophylline level if patient on theophylline at admission
- Sputum microscopy and culture if purulent
- further management
- give oxygen to keep SaO2 above 90%
- assess need for non-invasive ventilation:
- consider respiratory stimulant non-invasive ventilation not available
- assess need for intubation
- if poor response to nebulised bronchodilators then consider intravenous theophyllines
Once stable then consider for hospital-at-home or assisted-discharge scheme.
Before the patient is discharged then establish on optimal therapy and, if necessary, arrange multidisciplinary assessment.
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