What is a COPD exacerbation?

An exacerbation is a flare up of COPD symptoms.  The signs can include:

• Increased breathlessness (more than usual)
• Reduced walking distance
• Increase in coughing
• Changes in the amount/colour/thickness of phlegm
• Chest feeling tight
• New or increased wheeze

If there two or more of these symptoms are present in the patient, they need to act quickly to treat the flare up.  Treatment is usually with antibiotics and steroids, increased use of reliever inhalers and/or nebulisers, to help their chest to recover from the exacerbation.

The patient must take it easy when they have a flare up and balance out activity with periods of rest.

Most patients will be encouraged to have a self management plan and a 'stand-by' or 'rescue' pack of antibiotics and prednisolone that they can start taking when they have these symptoms.  However, if none of these measures are in place, then the GP or practice nurse must be contacted as soon as possible to arrange for a review and appropriate treatment.

More serious symptoms that may need emergency medical attention are:

• Difficulty in breathing
• The patient is no better after two days of treatment
• The patient is drowsy, confused or agitated
• There is chest pain
• There is a high fever
• The patient has increased swelling of the ankles
• The patient feels they cannot cope at home

Emergency medical attention may come in the form of an urgent consultation with a GP or calling 999 for an ambulance.

If the patient has any concerns in regards to their symptoms, they can contact the service