The Leading Peer-Reviewed Journal for the Primary Care Nursing Team
User log in




  

Respiratory disease: Management of acute exacerbations

Content developed by

Management of acute exacerbations in asthma and COPD

One of the aims of management, for both Chronic Obstructive Pulmonary Disease (COPD) and asthma, is to prevent, or reduce the incidence of acute exacerbations. This is achieved with the use of regular long term pharmacotherapy coupled with an awareness, by both patients and healthcare professionals, of the early warning signs of an impending exacerbation in order that appropriate interventions to prevent an attack becoming severe and potentially life threatening can be instituted promptly .

Regular review and ongoing therapy reduce the risk of acute exacerbations, but they can still occur, even in an otherwise optimally managed patient. It is therefore essential that healthcare professionals know how to assess the severity of these events and understand how to treat them appropriately.

British and international guidelines for asthma and COPD reinforce the importance of prompt and vigorous treatment for all exacerbations. It has been found that most asthma attacks requiring hospital admission are not sudden in onset but actually occur over a period of time which can range from a few hours, days or even weeks. People with COPD may delay or fail to seek help and the consequences of this can be a poorer and slower response to treatment and increased risk of admission. So in both asthma and COPD if signs of exacerbation are spotted early and effective action taken then it may possible to reduce the need for admission and the risk of fatality.

This resource, which is based on typical case scenarios, is offered at an intermediate level and includes five assessment questions to support your continuing professional development. Complete the resource to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.

Aims and Objectives

On completion of this resource you should have an understanding of:

  • The signs and symptoms that can help identify exacerbations of COPD or asthma
  • The objective measures used to determine the severity of an acute asthma exacerbation
  • Appropriate pharmacological treatment for acute exacerbations of COPD and asthma
  • The importance of follow-up and review after an acute exacerbation in order to minimise the likelihood of further attacks
  • The role of self -management plans and the use of ‘rescue medication’ in early treatment of exacerbations.

Reading List

British Thoracic Society Scottish Intercollegiate Guidelines Network British Guideline on the Management of Asthma, 2012 http://www.sign.ac.uk/guidelines/fulltext/101/

Department of Health An outcomes strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England, 2011 www.gov.uk/government/publications/an-outcomes-strategy-for-people-with-chronic-obstructive-pulmonary-disease-copd-and-asthma-in-england

NICE CG101 Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care (update), 2010. www.nice.org.uk/cg101

Further education and training

Treatment and management of acute exacerbations of asthma and COPD is included as part of all asthma and COPD diploma and degree level courses in addition to one day workshops provided by Education for Health. For further information please see:

Asthma eLearning Degree Module http://www.educationforhealth.org/shop.php/courses/106

COPD eLearning Degree Module http://www.educationforhealth.org/shop.php/courses/117/copd

Asthma eLearning Diploma Module http://www.educationforhealth.org/shop.php/courses/115

Asthma eLearning Diploma Module (Stirling)

http://www.educationforhealth.org/shop.php/courses/111

Asthma eLearning Diploma Module (London)

http://www.educationforhealth.org/shop.php/courses/170

COPD eLearning Diploma Module

http://www.educationforhealth.org/shop.php/courses/144/copd

COPD eLearning Diploma Module (Stirling)

http://www.educationforhealth.org/shop.php/courses/154/copd-stirling

Essentials of Asthma Workshop

http://www.educationforhealth.org/shop.php/courses/156

Essentials of COPD Workshop

http://www.educationforhealth.org/shop.php/courses/14/essentials-of-copd

Paediatric Asthma Workshop

http://www.educationforhealth.org/shop.php/courses/29