COPD exacerbation treatment: what to know

An exacerbation is a noticeable worsening of your usual COPD symptoms, such as breathlessness, wheezing, chest tightness, cough, or a change in phlegm. A chest infection, smoke, air pollution, or another illness can trigger it, although a clear trigger is not always found. A clinician may check your breathing, oxygen level, temperature, chest sounds, and response to your usual inhaler. Spirometry is generally used to assess airflow when you are stable rather than during a severe flare.

Follow your written COPD action plan if you have one, and use inhalers exactly as prescribed. Sit upright, keep calm, avoid smoke and other irritants, and take small rests between activities. Do not start leftover antibiotics or steroid tablets without medical advice: antibiotics help only some exacerbations, while steroids can have important effects and need the right dose and duration. A chronic disease review can check inhaler technique, vaccinations, exercise tolerance, and whether your everyday treatment needs adjustment. A smoking cessation programme can reduce continued airway irritation if you smoke.

Seek urgent medical help if breathlessness is rapidly worsening, you cannot speak in full sentences, your lips or face look blue or grey, you become unusually drowsy or confused, or your reliever inhaler is not helping as directed. Call emergency services if severe breathing difficulty prevents safe travel. Arrange prompt clinical review for a new change in phlegm, fever, chest pain, or symptoms that are not settling, because treatment may need to be changed.

Ask which symptoms should activate your action plan, how to check your inhaler technique, whether you need testing after recovery, and which warning signs mean you should attend hospital. You can also ask how to recognise a chest infection and how to keep a current list of your medicines.