COPD ER - steady state Assisted ventilation may be required...

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Emergency Treatment Goals of emergency treatment during an exacerbation of COPD are to correct tissue oxygenation, alleviate bronchospasm, and treat underlying cause of the exacerbation. Factors influencing ther- apy include the patient’s mental status, degree of reversible bronchospasm, recent medication us- age and evidence of potential toxicity, history of hospitalizations, exacerbations, and intubation, contraindications to medications, and causes or complications related to exacerbation. The first goal of treatment is to correct hypoxemia, aiming for PaO 2 greater than 60 mm Hg or a SaO 2 greater than 90%. Standard nasal cannula, simple face mask, Venturi mask, or non- rebreathing mask may be used. Monitoring of oxygenation and CO 2 levels with ABGs is import- ant. Improvement in oxygenation status after administration may take 20-30 minutes to reach a
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Unformatted text preview: steady state. Assisted ventilation may be required if adequate oxygenation is not achieved. Beta-adrenergic agonists and anticholinergics are first line therapies in the management of acute COPD. Beta-adrenergic agonist agents may be administered every 30 to 60 minutes if tolerated preferably in aerosolized forms. These medications should be accompanied by heart monitoring in patients with known heart disease. Inhaled ipratropium bromide is usually given with beta-ad-renergic agonists. Short term use (7 to 14 days) of corticosteroids improve FEV 1 in acute severe exacerbations of COPD. Antibiotics are given for treatment if underlying cause is an infection....
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