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Quick Chart
Introduction
  • Chronic obstructive pulmonary disease (COPD) is a lung disease characterised by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible.

Read the complete article; Chronic Obstructive Pulmonary Disorder (COPD) in the Medical Library > Pathophysiology.

Clinical Presentation
  • Respiratory distress
  • Sputum production
  • Cough
  • History of exposure to risk factors for the disease
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • COPD is an under-diagnosed, life-threatening lung disease (World Health Organisation).
  • Oxygen therapy should not routinely be stopped in these patients.
  • Low levels of oxygen may lead to confusion and impairment of judgement. This can render a patient incapable of making safe and reasoned decisions. In cases where the patient is unable to make sound decisions, the ambulance officers may act in the patient's best interests.
  • Removal of oxygen by hospital staff on arrival often occurs so that blood gas estimations may be done. This is part of hospital management and has no bearing on the need for oxygen during ambulance management.
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • If wheeze present, administer Salbutamol as per CPG
  • Consider applying cardiac monitor if trained and authorised
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
  • Administer Salbutamol as per CPG
  • Consider Ipratropium Bromide nebulised if indicated
  • Consider cardiac monitor
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Respiratory arrest
  • Cardiac arrest

References
References
Key Terms & Links
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