Sandbox/22
< Sandbox
Management
COPD Exacerbation ❑ Cough ↑ ❑ Dyspnea ↑ ❑ Sputum ↑ | |||||||||||||||||||||
Oxygen Supplement Indications for ICU Admission Indications for Hospitalization ❑ Marked increase in intensity of symptoms (eg, sudden development of resting dyspnea) ❑ Severe underlying COPD (GOLD 3—4 categories) ❑ Onset of new physical signs (eg, cyanosis, peripheral edema) ❑ Failure of an exacerbation to respond to initial medical management ❑ Presence of serious comorbidities (eg, heart failure or newly occurring arrhythmias) ❑ Frequent exacerbations (≥2 events per year) ❑ Older age (>65 years) ❑ Insufficient home support | |||||||||||||||||||||
Assessment of Exacerbation ❑ Chest radiograph (exclude alternative diagnoses) ❑ ECG (check coexisting cardiac problems) ❑ Whole-blood count (identify polycythemia, anemia, or leukocytosis) ❑ Electrolytes and glucose (identify electrolyte disturbances or hyperglycemia) | Severity of Exacerbation ❑ Mild (require change of inhaled treatment by the patient) ❑ Moderate (require medical intervention including a short course of ABx or oral steroids) ❑ Severe (require hospitalization) | ||||||||||||||||||||
†PaO2 <60 mm Hg with or without PaCO2 >50 mm Hg in ambient air