When is COPD an Emergency and When Should You Call Your Doctor

Woman with breathing difficulties
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When is COPD an emergency and when should you call your doctor?  If you have symptoms that could be a life-threatening emergency, don't read on or wait for your doctor to return your call.  Call 911 first.

Call 911 if You Have Any of These Symptoms

People with COPD still die today because they don't make it to the emergency room on time.  If you have any of these symptoms, call 911.

  • Severe or sudden shortness of breath.
  • Confusion or forgetfulness.
  • Difficulty awakening.
  • Chest pain.
  • Blue fingers or lips.
  • Coughing up more than a teaspoon of blood.
  • Extreme fatigue or weakness.
  • A need to use your break-through medications more often than recommended.

When Should You Call or See Your Doctor?

If you believe your symptoms are an emergency, call 911 and ask questions later.  Otherwise, be aware of these symptoms which should prompt you to call your doctor right away.

  • A worsening cough, either in frequency or in how deep.
  • A change in the amount of your sputum or the color of your sputum.
  • Coughing up blood - any blood at all.  Coughing up more than a teaspoon of blood is an emergency and coughing up just a third of a cup of blood is considered massive hemoptysis and has a mortality rate (death rate) of 30%.
  • Increased shortness of breath, a change in your perception of shortness of breath, or shortness of breath on awakening.
  • Need to elevate your head more than usual to sleep or the need for more pillows.
  • Increased wheezing.
  • Mild chest pain - If you experience moderate or severe chest pain, or new chest pain, you should dial 911.
  • Frequent morning headaches - Hypercapnia, an increased level of carbon dioxide in the blood, can cause morning headaches.
  • A fever, generally over 101.
  • Symptoms of the flu such as a fever, body aches, and sore throat.
  • Increased swelling in your legs, especially if it is not relieved with elevation.
  • Increased body weight - Gaining more than 2 pounds in a day or more than 5 pounds in a week can signal a worsening of COPD.
  • Anxiety and/or restlessness.
  • Inability to walk as far as you ordinarily can, or take as many stairs as you ordinarily could.
  • Increased need for "breakthrough" breathing treatments.
  • Increasing fatigue or weakness.

Don't wait for your COPD symptoms to become life-threatening to seek medical advice. If you experience any of these symptoms, call your doctor promptly to avoid an emergency situation.

COPD Monitoring and COPD Symptoms

When you have COPD, it's extremely important that you are closely monitored by your doctor for a worsening of your COPD symptoms, also referred to as COPD exacerbation.   Remember that the nature of COPD is one of repeated bouts of COPD exacerbations, and that your symptoms may vary with each episode.

Planning Ahead - Creating an Emergency Action Plan

It can be very helpful to plan ahead for emergencies with COPD, as exacerbations are the rule rather than the exception with this disease.

Print off this list to bring to your doctor, and ask what she would add knowing your specific condition.  Take time to talk with family members and loved ones who are near you, so they are also aware of symptoms that should prompt them to call 911 or urge you to call your doctor.

COPD can be a roller coaster ride of ups and downs, but preparing for those downward rides while you are riding smooth or improving, may not only decrease the impact of the exacerbations but can also save lives.

Sources:

National Library of Medicine. MedlinePlus. COPD flare ups. Updated 02/08/14. https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000698.htm

Suau, S., and P. DeBlieux. Management of Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease in the Emergency Department. Emergency Medical Clinics of North American. 2016. 34(1):15-37.

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