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COPD chronic visit

  • ROS

    • dyspnea (with strenuous exercise, fast walking or up hill, walking, walking for < 100 yards, activities such as dressing)
    • cough
    • sputum
    • symptoms better or worse from last time
    • smoking
    • exercise
    • wt loss
    • chest pain
    • COPD exacerbations and hospitalizations
  • Px

    • weight
    • SpO2
    • pulm
    • cardio
    • clubbing (red flag for cancer, ILD, bronchiectasis)
  • Labs

    • FEV1 (GOLD staging: >80% = mild, 50-80% = moderate, 30-50% = severe, <30% = very severe)
  • Tx

    • albuterol and ipratropium prn
    • LABA or tiotropium for anything more than intermittent symptoms
    • add fluticasone if needed
    • smoking cessation
    • exercise
    • pulm rehab for FEV1 < 80
    • long term O2 if PaO2 < 55 or SpO2 < 88
    • flu, pneumonia vax
    • surgery (volume reduction, transplant) if all the above fails and severely symptomatic

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.