Chronic Obstructive Pulmonary Disease

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Source: Institute for Clinical Systems Improvement (ICSI). Chronic obstructive pulmonary disease. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Jan. 65 p. Chronic Obstructive Pulmonary Disease Symptoms of or risk factors for COPD. A A = Annotation Ask about tobacco use / exposure at every visit. A Establish diagnosis of COPD *Medical history. *Physical examination. *Spirometry (pre- and post-bronchodilator). *Chest radiograph. A Acute exacerbation? A Evaluation. A Treatment. A Establish severity of stable COPD *Mild. *Moderate. *Severe. A Arrange for follow-up. A Positive response to treatment? A Step-care - pharmacologic approach for managing stable COPD. A Admit to hospital - out of guideline. A Other pharmacologic treatment. A Non-pharmacologic treatment - applicable to all levels of severity. *Encourage exercise. *Education. *Pulmonary rehab program for moderate, severe disease. A Assess for hypoxemia and hypercapnia and treat if indicated. A Long-term management *Schedule regular follow-up visits. *Evaluation and monitoring of comorbidities. *Refer to pulmonary specialist. *Surgical options for severe disease. *Discuss health care directives (advance directives) and goals of care. A All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.