Algorithm A1: Acute Exacerbaton

Patients with acute exacerbation of COPD presenting to primary care
Is O2 saturation less than 90%? Administer oxygen therapy to keep saturation greater than or equal to 90%
Is there evidence of respiratory infection? [C] Consider antibiotic treatment [D]
Consider and treat other factors contributing to COPD exacerbation [E] Box 5 no to box 6
Assess patient's ability to user inhaler effectively
Initiate pharmacotherapy
Is patient's condition improved and patient is able to go home? [G] Has patient's condition improved in one to three days? [H] Box 10 yes to box 11
Referral to emergency room. Go to Module B1 Reassess treatment or refer to specialist for consultation or admission Slowly taper intensity of bronchodilator and steroids to baseline maintenance regimen [I] Follow up
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