1. < COPD: Chronic obstructive pulmonary disease

Can we talk about emergency plans?

Posted by lesleys56 @lesleys56, 2 days ago

Everything I read about stage 4 COPD advises to put together a plan for caregivers in case of exacerbations. Like what? Rush me to the hospital? The one I had yesterday was terrifying and oxygen or emergency inhaler wouldn't have helped because of the amount of mucus.

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Mentor
Sue, Volunteer Mentor | @sueinmn | 2 days ago

@lesley56 I do not have COPD, but have Asthma and another lung disease, Bronchiectasis. I worked with my pulmonologist to create a plan that works for me - for now. At some point we may have to change it. I compare it to the emergency plan one makes if they are diabetic and tend to low blood sugar.

For now, my plan is - if I sense an exacerbation coming - more fatigue, more coughing, more mucus, fever, respiratory infection - I initiate higher levels of self-treatment.
Step one - Begin monitoring oxygen levels with pulse oximeter - if below 90 and doing the following treatments, go to the ER. Increase nebs from once/twice a day using levalbuterol and budesonide to as often as every 4 hours, sit up or recline to help breathing, cough up as much mucus as possible.
Step two - after 24 hours with no improvement, continue step one and start oral prednisone - we have already set the dose, and I always have a filled Rx on hand.
Step three - if steps one & two don't give improvement - start oral antibiotics, call pulmonologist and make arrangements for someone to take me to the ER if necessary.

We review our plan once a year, and so far I have managed to stay at steps one & two - even when I had Covid this fall.

If your condition, at COPD stage 4, is more prone to rapid decline, your plan may be different. For example, you may have a tendency to "trap" carbon dioxide in your lungs, which can quickly lead to confusion or non-responsiveness. So, if you get an exacerbation, you might need to have another person with you 24/7 during it, and they might need some written directions of when to wait, when to take you to the ER, and when to call 911.

Do you have someone who can be with you during an exacerbation? Can you make a plan with your pulmonologist?

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1 reply
lesleys56 | @lesleys56 | 2 days ago
In reply to @sueinmn "@lesley56 I do not have COPD, but have Asthma and another lung disease, Bronchiectasis. I worked..." + (show)
@sueinmn

@lesley56 I do not have COPD, but have Asthma and another lung disease, Bronchiectasis. I worked with my pulmonologist to create a plan that works for me - for now. At some point we may have to change it. I compare it to the emergency plan one makes if they are diabetic and tend to low blood sugar.

For now, my plan is - if I sense an exacerbation coming - more fatigue, more coughing, more mucus, fever, respiratory infection - I initiate higher levels of self-treatment.
Step one - Begin monitoring oxygen levels with pulse oximeter - if below 90 and doing the following treatments, go to the ER. Increase nebs from once/twice a day using levalbuterol and budesonide to as often as every 4 hours, sit up or recline to help breathing, cough up as much mucus as possible.
Step two - after 24 hours with no improvement, continue step one and start oral prednisone - we have already set the dose, and I always have a filled Rx on hand.
Step three - if steps one & two don't give improvement - start oral antibiotics, call pulmonologist and make arrangements for someone to take me to the ER if necessary.

We review our plan once a year, and so far I have managed to stay at steps one & two - even when I had Covid this fall.

If your condition, at COPD stage 4, is more prone to rapid decline, your plan may be different. For example, you may have a tendency to "trap" carbon dioxide in your lungs, which can quickly lead to confusion or non-responsiveness. So, if you get an exacerbation, you might need to have another person with you 24/7 during it, and they might need some written directions of when to wait, when to take you to the ER, and when to call 911.

Do you have someone who can be with you during an exacerbation? Can you make a plan with your pulmonologist?

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This is EXTREMELY helpful. Thank you so much!

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