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Thursday, November 5, 2009

The COPD Action Plan

Other than quitting smoking, one of the most important steps for any patient with Chronic Obstructive Pulmonary Disease (COPD) is to work with his doctor on a COPD Action Plan. This plan will help him decide exactly what to do when he observes his early warning signs of an impending COPD exacerbation.

Way too often I have a COPD patient come into the emergency room who waited way too long to seek help. This is usually the case with that first exacerbation. The patient may be scared and doesn't really understand what's going on. Or, he is modest and thinks by taking extra breathing treatments and over medicating can solve his problem on his own.

Usually, however, waiting too long to seek help when you have COPD only makes the exacerbation worse. So, to help COPD patients decide what to do next time this happens, we educate on what a COPD Action Plan is.

First they must be vigilant and pick up on their own early warning signs of COPD. The next time they see any of these signs they need to put this plan into action. What follows is a sample plan from that I think should work pretty well for most COPD patients. However, every COPD patient should work with his own doctor to build a plan tailored just for him.

Here is a sample COPD Action Plan from

Call immediately: If forgetfulness, confusion, slurring of speech or sleepiness occurs during an acute respiratory infection.

Call within 6-8 hours: If shortness of breath or wheezing does not stop or decrease with inhaled bronchodilator treatments one hour apart.

Call within 24 hours: If you notice one or more of the following severe respiratory symptoms:

  • Change in color, thickness, odor or amount of sputum persists

  • Ankle swelling lasts even after a night of sleeping with your feet up

  • You awaken short of breath more than once a night

  • Fatigue lasts more than one day.

It's that simple. Teach your COPD patients how to stay out of the hospital by providing them with this COPD Action Plan, or by encouraging them to create one of their own with their doctor.

If you have COPD, well here you go.

Sure the COPDer might require an occasional recharge at a nearby hospital. But by following a good COPD Action Plan most exacerbations should easily be treated by a simple call to your doctor and a quick visit to his office.


Steve said...

Another very helpful post Rick!

Steve said...

Yes Rick, Im taking both Advair AND Qvar , as well as prednisone. A triple whammy.

You can check out the debate we had regarding the effectiveness of Qvar
over at Medpedia

Glenna said...

We should staple those guidelines to the forehead of every COPDer. Oh wait. That wasn't nice. Sorry, I'm feeling particularly cranky today. Hmmm...have to work tonight. It might be better if they put me in the NICU or Peds from that comment, LOL! Great post. And this probably shows how long it's been since I've swung by but love the new blog layout and graphics. Very nice!