Chronic Obstructive Pulmonary Disorder

UNCONTROLLED WHEN PRINTED

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.

Clinical Presentation

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

Primary Survey
Position patient appropriately (sitting patient upright or in a position of comfort)
Conduct Vital Sign Survey, particularly respiratory rate and pulse oximetry
Consider oxygen therapy
- If patient is already on home-oxygen, leave / continue the patient on oxygen
- Titrate SpO₂ using the appropriate mask to a target of 88–92%

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)

Additional Information

References

Key Terms & Links

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Directorate

Clinical Services

Responsible Manager

Head of Clinical Services

Published Date

Review Date