- Chronic obstructive pulmonary disease (COPD) is a preventable, treatable disease that is characterized by persistent airflow limitation. Emphysema or destruction of the gas-exchanging surfaces of the lung (alveoli), is a pathological term that is often (but incorrectly) used clinically and describes only one of several structural abnormalities present in patients with COPD. Chronic bronchitis, or the presence of cough and sputum production for at least 3 months in each of 2 consecutive years, remains a clinically and epidemiologically useful term. It does not, however, reflect the major impact of airflow limitation or morbidity and mortality in COPD patients.
STEP 1: Screening and Recognition of the Newly Admitted Patient For COPD
- Consider evaluating the patient for COPD if any of the following signs, symptoms, or risk factors are noted:
- Abnormal breath sounds (e.g., crackles, prolonged expiratory phase, rales, reduced air movement, rhonchi, wheezing).
- Abnormal pulse oximetry and vital signs from baseline.
- Activity intolerance in performing activities of daily living (ADLs) because of dyspnea.
- Chronic cough, sputum production or dyspnea at rest or with activity.
- Cognitive problems, which may reflect poor oxygenation and/or hypercarbia.
* This pocket guide is a companion to the comprehensive AMDA COPD Clinical Practice Guideline.
STEP 2: Develop a Differential Diagnosis
STEP 3: Assess the Severity of the Patient’s COPD
STEP 4: Assess the Stability of the Patient's COPD
- Patients with COPD should be assessed on admission and periodically during the course of care for worsening symptoms that may reflect acute exacerbation of their disease