Chronic obstructive pulmonary disease exacerbation resident survival guide: Difference between revisions
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{{Family tree | | | | B01 | | | |B01=Admission}} | {{Family tree | | | | B01 | | | |B01=Admission}} | ||
{{Family tree | | | | |!| | | | |}} | {{Family tree | | | | |!| | | | |}} | ||
{{Family tree | | | | C01 | | | |C01='''Assessment''' :1-O2 sat +ABG 2-CXR 3-EKG 4-CBC | {{Family tree | | | | C01 |~| C02 | |C01='''Assessment''' :1-O2 sat +ABG 2-CXR 3-EKG 4-CBC | ||
'''Management''' :1-Inhaled bronchodilators 2-Systemic Corticosteroids 3-Empirical antibiotics 4-O2(Target Sat >90%) }} | |||
'''Management''' :1-Inhaled bronchodilators 2-Systemic Corticosteroids 3-Empirical antibiotics 4-O2(Target Sat >90%)| C02=tahseen }} | |||
{{Family tree | | | | |!| | | | |}} | {{Family tree | | | | |!| | | | |}} | ||
{{Family tree | | | | D01 | | | |D01=Resp acidosis? PH≤35?,PaCo2≥45 | {{Family tree | | | | D01 | | | |D01=Resp acidosis? PH≤35?,PaCo2≥45 | ||
Severe dyspnea signs?(Accessory muscles use ,paradoxical motion of abdomen ,retraction of intercostal space}} | Severe dyspnea signs?(Accessory muscles use ,paradoxical motion of abdomen ,retraction of intercostal space}} | ||
{{Family tree | |, | {{Family tree | | |,|-|^|-|.| | }} | ||
{{Family tree | E01 | {{Family tree | E01 | | |E02 |E01=No | E02= Yes}} | ||
{{Family tree | |!| | | |!| |}} | |||
{{Family tree | F01 | | |F02|F01=Continue the same management |F02=ICU Admission '''NIV''' }} | |||
{{Family tree | | | | | |!| |}} | |||
{{Family tree | | | | | |G01 |G01= Unable to telorate NIV? | |||
Sever hemodynamic instability? | |||
Resp/Cardiac arrest ? }} | |||
{{Family tree | | | | | | | |!| | |}} | |||
{{Family tree | | | | | | | H01 | |H01=Invasive mechanical ventilation}} | |||
{{Family tree/end}} | {{Family tree/end}} | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 20:58, 25 November 2013
Overview
COPD exacerbation commonly caused by infections, should be recognized when anyone or more of the following appears acutly in chronic COPD patient[1]:
- Worsening cough
- Increasing dyspnea
- Increasing in sputum production more than the baseline for chronic COPD Pts[1]:.
Differential Diagnosis
- Asthma
- CHF
- PE
- ACS
- Pneumothorax
- Pneumonia
- Lobar atelectasis
Management
| COPD Exacerbation↑cough↑dyspnea↑sputum or ↑wheezing ,fever or chest tightness | |||||||||||||||||||||
| Admission | |||||||||||||||||||||
| Assessment :1-O2 sat +ABG 2-CXR 3-EKG 4-CBC
| tahseen | ||||||||||||||||||||
| Resp acidosis? PH≤35?,PaCo2≥45
| |||||||||||||||||||||
| No | Yes | ||||||||||||||||||||
| Continue the same management | ICU Admission NIV | ||||||||||||||||||||
| Unable to telorate NIV?
Sever hemodynamic instability? Resp/Cardiac arrest ? | |||||||||||||||||||||
| Invasive mechanical ventilation | |||||||||||||||||||||
References
- ↑ 1.0 1.1 Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P; et al. (2007). "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary". Am J Respir Crit Care Med. 176 (6): 532–55. doi:10.1164/rccm.200703-456SO. PMID 17507545.