Hospital or community setting for management of exacerbation of COPD

• factors which favour treatment in hospital
  • not able to cope at home
  • severe breathlessness
  • general condition is poor/ deteriorating
  • level of activity is poor/confined to bed
  • cyanosis is present
  • worsening peripheral oedema
  • impaired level of consciousness
  • patient is already receiving long-term oxygen therapy
  • patient is living alone/not coping
  • acute confusion is present
  • exacerbation has had a rapid rate of onset
  • there is significant comorbidity particularly cardiac disease and insulin-dependent diabetes
  • SaO2 < 90%
  • changes on the chest radiograph are present
  • arterial pH level < 7.35
  • arterial PaO2 < 7 kPa

For further details consult the full guideline (1).

Reference:

1. National Institute for Health and Clinical Excellence (NICE) 2019. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care.