Welcome to Pulmonary Rehab

Avoiding Exacerbations

Babette Parthum, RRTClinical CoordinatorRespiratory Therapy

What is an Exacerbation of COPD?

● A flare-up or episode when your breathing gets worse than usual and you become sick.

● Most often linked to an infection, however, can also be noninfectious (ie air pollution).

● They can be serious and cause a trip to the doctor, ER, or admittance to the hospital.

Early Warning Signs of an Acute Exacerbation● Wheezing, or more wheezing than normal● Coughing more than usual● Shortness of breath that is worse than

normal● An increase in the amount of mucus● Change in the color of your mucus● Shallow or rapid breathing● Fever● Confusion or excessive sleepiness● Swelling in your feet or ankles

Treatment of an Acute Episode

● Eliminate respiratory irritants● Optimize bronchodilation● Steroid therapy● Antibiotics● Oxygen as required

Indications for Hospitalizations for AECOPD

● Marked increase in intensity of symptomso Sudden development of shortness of breath at resto Change in vital signs (heart rate, blood pressure,

and/or O2 saturation)● Severe underlying COPD● Onset of new physical signs

o Cyanosiso Peripheral edema

Indications for Hospitalizations for AECOPD

● Failure of exacerbation to respond to initial medical management

● Significant comorbiditieso Pneumonia, arrhythmias, CHF, liver or

renal failure● Diagnostic uncertainty● Insufficient home support

Tips to help you avoid acute exacerbations● See your doctor at your regularly scheduled

appointments, even if you are feeling fine.● Get your flu shot every year.● Get your pneumonia shot every 5 years.● Wash your hands often for 20 seconds with

warm water and antibacterial soap.● Avoid touching your mouth, eyes, nose in

public

Tips to help you avoid acute exacerbations

● Stay away from crowds, especially in cold and flu season.

● Use your own pen, especially when signing in at your doctor’s office or other health appointments.

● Get plenty of sleep.● Drink plenty of water. Thick sticky mucus is

more likely to get stuck in your lungs.

Prevention of AECOPD

Smoking Cessation and Vaccinations ↓

Self-Management Education with Written AECOPD Action Plan

↓Regular long-acting bronchodilator therapy

↓Regular Inhaled Corticosteroid/Long-Acting β-Agonist therapy

↓Pulmonary rehabilitation

↓Oral corticosteroids for moderate/severe AECOPD

References

● American Thoracic Society● COPD Foundation● European Respiratory Society Task

Force