COPD Exacerbation Plan: Care Instructions

Overview

If you have chronic obstructive pulmonary disease (COPD), your symptoms may get worse over a short time and stay bad. This is called an exacerbation (say "egg-ZASS-er-BAY-shun") or flare-up. Your shortness of breath, cough, or mucus may get worse.

Many irritants or triggers can cause a flare-up. Common triggers are respiratory infections such as colds, the flu, and pneumonia. Other triggers include indoor and outdoor air pollution such as smoke, fumes, and soot.

Work with your doctor to make a plan for dealing with a flare-up. You can better manage it if you plan ahead.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself?

During an exacerbation

• Do not panic if you start to have one. Quick treatment may help you prevent serious breathing problems. If you have a COPD exacerbation plan that you developed with your doctor, follow it.
• Take your medicines exactly as your doctor tells you.
  • Use your quick-relief inhaler as directed by your doctor. If your symptoms do not get better after you use your medicine, call your doctor, or seek immediate medical care. Call an ambulance if needed.
  • Use your inhaler or nebulizer correctly. Ask your doctor, pharmacist, or respiratory therapist how to use each of your inhalers or nebulizers.
  • If your doctor has given you steroid pills, take them as directed.
  • Your doctor may have given you a prescription for antibiotics, which you can fill if you need it.
  • Talk to your doctor if you have any problems with your medicine. And call your doctor if you have to use your antibiotic or steroid pills.
  • Use a breathing technique, such as pursed-lip breathing. This may help you breathe easier during an exacerbation.

Preventing an exacerbation

• If you smoke, try to quit. If you can't quit, cut back as much as you can. Quitting is the most important step you can take to prevent more damage to your lungs and prevent problems. If you smoke, it is never too late to stop. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These may increase your chances of quitting for good.
• Take your daily medicines as prescribed.
• Try to avoid infections such as COVID-19, colds, and the flu.
  • Wash your hands often.
  • You may want to wear a mask when you go to public indoor places.
  • Try to avoid sick people.
• Stay up to date on vaccines. This includes getting a flu vaccine every year.
  • Encourage those you live with to also stay up to date on vaccines. Then they can avoid getting sick and infecting you.
• Try to avoid things that could make your symptoms worse. These include secondhand smoke, chemical fumes, factory dust, soot, and air pollution. Talk to your doctor about ways to protect yourself if you are exposed to substances that irritate your lungs at home, outside, or at work.
• Take care of your teeth and gums. Get regular dental checkups. This can help you stay healthy.

When should you call for help?

Call anytime you think you may need emergency care. For example, call if:

• You have severe trouble breathing.
• You have severe chest pain.

Call your doctor now or seek immediate medical care if:

• You have new or worse shortness of breath.
• You have new or worse chest pain.
• You cough up blood.
• You have a fever.
• You have used your quick-relief medicine or followed your plan for what to do if your symptoms get worse, but you are still short of breath.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You are coughing more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
• You have new or increased swelling in your legs or belly.
• You have feelings of anxiety or depression.
• You need to use your antibiotic or steroid pills.
• You are not getting better as expected.