Managing COPD Flare-Ups: How to Recognise and Respond for Better Outcomes

Introduction

If you or someone you love has COPD, it is very important to know how to recognise and respond to a COPD flare-up. People who receive earlier treatment for COPD flare-ups of chronic obstructive pulmonary disease (COPD) are more likely to fare better, and are less likely to need emergency hospital care.

Studies show that many patients delay seeking help or do not tell their medical teams about any worsening symptoms.

This article will discuss the typical signs of a COPD flare-up and what to do about them.

About treatment for COPD

Treatment for COPD aims to:

• • prevent and control your day to day symptoms

• • help your lungs to work better

• • help you live a longer and healthier life

• • reduce the number and severity of exacerbations or flare ups

Understanding and helping to manage  COPD flare-ups

What is a COPD flare up?

Someone living with COPD is likely to experience periods during which their symptoms are stable and controlled by their medicines and inhalers, and periods when their condition “flares up” and is suddenly much worse and needs extra care. COPD flare-ups – also known as acute exacerbations – vary in severity and can be relatively mild or very serious requiring intensive hospital care. At the start of a flare up, it can be impossible to know how serious it might become but prompt care can help to avoid things escalating.

Recognising the signs of a COPD flare up or exacerbation

Signs of a flare up can vary but typically, the early indications of a flare up include:

• • Coughing more than usual

• • Shortness of breath which is worse than usual

• • An increase in the amount of phlegm

• • Changes in the colour of phlegm  – yellow, green, tan or bloody

Although it’s normal for COPD symptoms to vary a bit from day to day, if these symptoms last for more than a day then they might indicate a flare up and you should seek or follow medical advice.

Managing exacerbations of COPD

Adults living with COPD should have regular appointments with their GP or practice nurse (or in some cases hospital specialist) to assess and monitor their condition and its treatment. As part of this ongoing care, they should be advised how to recognise a flare up and what to do about it. The action plan might include a prescription for a “rescue pack”.

You can ensure that the person you care about is getting regular monitoring and advice and that they know about, and how best to deal with, any flare ups. You can also help them understand and follow this advice.

What is a rescue pack?

Some COPD patients will be given extra medicine to keep at home and to take if they are having a flare up. This pack of medicine is sometimes known as a “rescue pack” and might contain antibiotics and/or steroid tablets depending on what the best treatment is likely to be for them.

The great thing about a rescue pack is that it’s there, on standby, for whenever it is needed. It ensures that treatment can be started early on without waiting for either a medical appointment or for a pharmacist to dispense a prescription.

Using a COPD Rescue Pack

If you are not sure whether or when to start using a rescue pack you can check with your doctor or nurse or the out of hours service (NHS 111). If you start using a rescue pack and things do not seem to be improving you should always seek urgent medical advice.

If you use your rescue pack as instructed and things get better, you should still contact your doctor or nurse to let them know what has been happening. This will ensure that they can:

• • arrange a replacement pack

• • fully understand how often you are experiencing flare ups

• • monitor how much extra treatment you need

• • consider alternative ways of treating or preventing flare ups

• • review and update your ongoing COPD care plan