What are the treatment options for chronic obstructive pulmonary disease (COPD) in the ED?

Updated: Nov 13, 2020
  • Author: Paul Kleinschmidt, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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In addition to oxygen, proper ED care may comprise bronchodilators, antibiotics, magnesium, CPAP or biphasic positive airway pressure (BiPAP), Heliox (ie, mixture of helium and oxygen), and definitive airway management via intubation. [3] All of these should be considered in the context of the individual patient's condition. 

Not all chronic obstructive pulmonary disease (COPD) exacerbations have a reversible (bronchospastic) component to their process, but predicting which ones will and which ones will not is an exercise in futility. Some evidence even shows that the amount of bronchospasm and response to bronchodilators may vary with the same patient from exacerbation to exacerbation.

Keep in mind that altered level of consciousness is a contraindication for BiPAP, so carefully examine patients to determine appropriateness of its use.

For more information, please see Medication.

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