COPD

COPD

Think Observation or Home if:

• COPD close to or at baseline — CONSIDER D/C
• COPD signs/symptoms worse than baseline but no persistent hypoxia (O2 sat<90) or increased O2 need
• COPD signs/symptoms worse than baseline but improved after treatment in ED

Think Inpatient if:

• Signs/symptoms worse than baseline AND
  • Severe underlying COPD (FEV < 50%)
  • High risk ACUTE comorbidity (pneumonia, CHF, PE, pneumothorax)
  • No/minimal improvement after ED treatment
  • Persistent hypoxia or increased O2 need
  • Acute respiratory failure
    • New hypoxia and/or hypercarbia PLUS evidence of respiratory distress and/or lethargy on exam (ED note counts!)
    • If requires BIPAP or vent – CLEAR resp failure
    • Chronic Respiratory Failure – if on home O2