Depending on the severity of exacerbation and/or the severity of underlying disease, an exacerbation can be managed in either the outpatient or inpatient setting (1).
Factor | Treat at home | Treat in hospital |
able to cope at home | yes | no |
breathlessness | mild | severe |
general condition | good | poor/deteriorating |
level of activity | good | poor/confined to bed |
cyanosis | no | yes |
worsening peripheral oedema | no | yes |
level of consciousness | normal | impaired |
already receiving long-term oxygen therapy | no | yes |
social circumstances | good | living alone/not coping |
acute confusion | no | yes |
rapid rate of onset | no | yes |
significant comorbidity (particularly cardiac disease and insulin-dependent diabetes) | no | yes |
SaO2 < 90% | no | yes |
changes on chest radiograph | no | present |
arterial pH level | >=7.35 | < 7.35 |
arterial PaO2 | >= 7 kPa | < 7 kPa |
Reference:
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