Chronic obstructive pulmonary disease (COPD) is the name for a group of chronic conditions, including emphysema and chronic bronchitis, that make it difficult to breathe. COPD flare-ups are called exacerbations. People in the later stages of COPD have reduced lung function and are likely to have more frequent exacerbations.

Some exacerbations will last for a few days and then resolve on their own. Other exacerbations can last for weeks and will need medical treatment and even hospitalization.

Exacerbations can lead to a COPD emergency. This is a medical emergency that requires prompt care in an emergency department.

In the days leading up to a COPD emergency, your symptoms might be more severe than usual. It can often be difficult to know if you’re getting a cold, having an allergy flare-up, or experiencing symptoms of your COPD. It’s a good idea to tell your primary care doctor about your symptoms, or even visit an urgent care center.

Some symptoms signal a COPD emergency. It’s important to call emergency services and get immediate care if you experience any of these symptoms.

Signs of a COPD emergency include:

A COPD emergency is a medical emergency. It’s very important that you receive care right away.

Head to your nearest emergency room or call emergency services. A friend, family member, or designated emergency contact person can also help you get to the emergency room.

It’s a good idea to bring important documents, such as:

  • your insurance information
  • names and contact information for your doctors
  • list of medications and their dosages

It’s helpful to prepare this information ahead of time to be ready in case of an emergency. You can even make copies for family members and other trusted emergency contacts.

The primary goal of your hospital stay will be to help you breathe more easily. Medical staff will give you supplemental oxygen and medication to make this happen.

You might get medications like steroids and antibiotics. You could also receive a form of noninvasive ventilation, such as bilevel positive airway pressure (BiPAP) therapy.

Hospital staff will also monitor the amount of oxygen in your blood through lab tests. This will help them determine what treatments you need. The tests might also help them find the cause of your COPD emergency.

Once your breathing is under control, you might move to a hospital room for a few days of observation. You’ll likely meet with respiratory therapists and receive breathing treatments to help clear your airways. Medical staff will monitor your oxygen levels throughout your stay.

Your medications might change as a result of your hospitalization, and you might have portable oxygen ordered for home use. If you were already using portable oxygen, you might have the level or delivery method adjusted.

A COPD action plan is a personal plan you make with your doctor to manage your COPD. Your plan will include:

  • how to take your medication
  • when to take your medication
  • how to track your good days
  • what symptoms to look out for
  • when to contact your doctor
  • when to get emergency care

Additionally, a plan can help you set and manage COPD goals such as:

  • getting vaccines
  • quitting smoking
  • eating healthy
  • getting active

A COPD action plan is a great way to take control of your COPD. You can see the American Lung Association’s COPD Action Plan template here. Other associations and countries have their own versions, but all COPD action plans contain the same basic elements.

COPD action plan zones

Your action plan organizes your symptoms into three zones:

  • Green zone: no symptoms, or usual symptoms.
  • Yellow zone: symptoms more intense than usual.
  • Red zone: severe symptoms.

If your action plan is in the red zone, it’s time to go to the hospital.

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Doctors define a COPD exacerbation as a worsening of symptoms that leads to a necessary change in treatment.

It’s common to see an increase in some COPD symptoms before an exacerbation occurs. These symptoms often include:

  • fatigue that lasts for more than 1 day
  • trouble sleeping
  • coughing up mucus that is different in color, thickness, or amount than usual
  • coughing or wheezing more than usual
  • shortness of breath that is more than what is usual for you
  • swelling in your legs or ankles
  • needing to use more supplementary oxygen than what is usual for you

A COPD exacerbation is often a medical emergency, and it can harm your lung function. Fortunately, you can take steps to lower your risk of an exacerbation.

  • Take your COPD medications as prescribed by your doctor.
  • Stay on your COPD treatment plan.
  • Avoid things that trigger your COPD.
  • Quit smoking, if you smoke.
  • Maintain a moderate weight.
  • Practice breathing exercises and stress reduction techniques.
  • Get a flu vaccine.
  • Ask your doctor if you need a pneumonia vaccine.
  • Talk with your doctor about additional treatment options if you’re still experiencing COPD symptoms.

A COPD exacerbation can intensify as your COPD progresses. You might need medical treatment to resolve the exacerbation.

COPD emergencies require hospitalization. If you notice warning signs of an emergency, it’s important to get to an emergency department right away. A hospital stay will help open your airways and make it easier to breathe.

A COPD action plan is one of the best ways to manage your COPD. You and your doctor can work together to develop your plan. It can help you with:

  • keeping track of your treatments
  • monitoring your symptoms
  • meeting goals
  • lowering the risk of exacerbation
  • knowing when to contact your doctor or go to the hospital