investigation of exacerbation of COPD

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Diagnosis of an exacerbation is usually made clinically. In patients who have their exacerbation managed in primary care:

  • sending sputum samples for culture is not recommended in routine practice
  • pulse oximetry is of value if there are clinical features of a severe exacerbation

In all patients with an exacerbation referred to hospital

  • a chest radiograph should be obtained
  • arterial blood gas tensions should be measured and the inspired oxygen concentration should be recorded
  • an ECG should be recorded (to exclude comorbidities)
  • a full blood count should be performed and urea and electrolyte concentrations should be measured
  • if sputum is purulent, a sample should be sent for microscopy and culture
  • blood cultures should be taken if the patient is pyrexial (1)


Last reviewed 10/2018