Managing Exacerbations of COPD in the ED: Which Strategies Are Best?

Proper management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may result in better patient outcomes and less strain on emergency health care systems, according to the results of a recent clinical review.

The authors of the review utilized 2 hypothetical case studies to outline management strategies and define what should be physicians’ key considerations for all patients with AECOPD who present to the emergency department (ED). They note that AECOPD is a key indicator of COPD disease progression, and proper management can reduce the risk of treatment failure and hospital readmissions. 

Admission of patients with COPD to the ED must be followed by a correct diagnosis early on as this patient population often has comorbidities such as cardiovascular disease, diabetes, or bronchiectasis, that can complicate proper treatment, the researchers wrote.

Emergency care physicians must consider the patient’s history, the presence of these comorbid conditions, the severity and intensity of symptoms of the disease, and how the patient responds to therapy, before discharging a patient with AECOPD.

Discharge plans for these patients must include medication reconciliation, patient demonstration of their proper inhaler usage, and physician follow-up in order to prevent hospital readmissions of these patients. 

“An effective assessment, accurate diagnosis, and appropriate discharge plan for patients with AECOPD could improve treatment outcomes, reduce hospitalization, and decrease unplanned repeat visits to the ED,” the researchers concluded.

—Leigh Precopio

Reference:

Sorge R, DeBlieux P. Acute exacerbations of chronic obstructive pulmonary disease. J Emerg Med. 2020;59(5):643-659. doi: 10.1016/j.jemermed.2020.07.001