Chronic obstructive pulmonary disease

Katie Walker, Christine Jackman

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Other


Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. It is one of the leading causes of death and disability in the world. Acute exacerbations are characterized by an increase in dyspnea, cough and sputum. Emergency Department assessment should include determining the diagnosis and verifying the cause and severity of the current attendance. Investigations available to assist include bedside tests, imaging, pathology and spirometry.
Therapy includes oxygen, with doses carefully controlled to keep oxygen saturation levels at 88-92% to avoid hypercarbia. Bronchodilators and systemic steroids are recommended for acute exacerbations. Antibiotics are useful in the sickest patients. The use of non-invasive ventilation in acute respiratory failure is associated with reduced mortality, reduced rates of intubation and reduction in treatment failure. Intensive care therapy with intubation and ventilation should be considered in the context of the overall patient goals-of-care and health trajectory.
Patients should be admitted when more intensive therapy is required than can be provided in the community. Discharged patients should have inhaler technique verified, smoking cessation counseling and should be referred for ongoing community care, including immunisations, medication monitoring, pulmonary rehabilitation and COPD action and homecare plans.
Original languageEnglish
Title of host publicationTextbook of Adult Emergency Medicine
Subtitle of host publicationRespiratory Emergencies
EditorsPeter Cameron, Mark Little, Biswadev Mitra, Conor Deasy
Place of PublicationEdinburgh
Number of pages5
ISBN (Electronic)9780702076251
ISBN (Print)9780702076244
Publication statusPublished - 1 Aug 2019


  • Pulmonary disease, chronic obstructive
  • Emergency treatment
  • Emergency Medicine
  • Critical Care
  • analysis, blood gas
  • Non-invasive ventilation
  • Lung disease
  • Emergencies

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