(Note: a consensus is not science. But, since since we are humans and not God, we must resort to debating the studies, and that's why we usually talk about consensus's.)
But, if you are admitted to the hospital, and you note that you smoked, you are automatically diagnosed with COPD.
And if you are diagnosed with COPD, you automatically need Duoneb QID.
This is true even if the patient never had a pulmonary function test (phooey on the GLOBAL COPD Guidelines). And this is true even if the patient did have a PFT done and it was normal. None of those things mattered. We are covering our bases. If you smoked, you get treated as though you are a COPDer.
And you can go ahead and DC the order per protocol. The doctor will just reorder it.
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