When you have chronic obstructive pulmonary disease (COPD), at-home treatments like medications or using a portable oxygen tank can often manage symptoms like coughing, wheezing, and shortness of breath. But if your symptoms become worse, you may need to go to the hospital. In 2020, more than 335,000 people were admitted to the hospital because of COPD.
Getting more intense treatments and round-the-clock care can make you more comfortable and prevent severe complications.
Signs That a Flare Is an Emergency
If you live with COPD, you’re likely to have exacerbations, or flares, when your symptoms get worse. Call 911 or go to the closest ER if you have any of these symptoms:
- Finding it hard to breathe or talk
- Chest pains
- Fever or chills
- Racing heart
- Blue or gray fingers, fingernails, or lips
- Slurred speech
- Confusion
- Dizziness
- Coughing up blood
- Finding it hard to stay awake or to wake up from sleep
What to Expect
When you go to the hospital, you’ll probably first see a doctor in the ER who will do a physical exam and order lab and imaging tests like a chest X-ray to get more insight. Then they’ll start a treatment to help ease your symptoms. In some cases, you may start to feel well enough to safely go home. But you could also be admitted to the hospital for more care.
Based on your symptoms, you could stay overnight or get care in the hospital for several days.
While you’re in the hospital:
Along with the doctor, nurse practitioner, or physician assistant who oversees your care, you may be treated by a respiratory therapist. This type of provider has special training in lung care.
The treatments you could get include:
- Oxygen therapy: You’ll likely get extra oxygen through a face mask or small tube in your nose. It will help you breathe more easily.
- Nebulizer or inhalers: These medicines go into your lungs so they can start working right away.
- Chest physiotherapy: While you sit or lie down, a health care provider may tap on certain points on your back to shake loose any excess mucus.
- Noninvasive ventilation: A device like a CPAP machine can help push air into your lungs. It doesn’t have tubes that go inside your body. Instead, you’ll wear a special mask.
- Ventilation: In severe cases, a medical device called a ventilator can do some or all of your breathing. But this is an extreme measure. It won’t be done unless your doctor feels it’s needed and you or someone in charge of your care agrees.
- Tracheostomy: A doctor will put a special tube into your neck to help you breathe and drain extra mucus. It can be removed when your symptoms get better.
- Antibiotics: If your doctor thinks you have bacteria in your airway or have an infection like pneumonia, you’ll start a course of antibiotics.
- Corticosteroids: These drugs are often a standard treatment for COPD flare-ups. They can quickly lessen your symptoms.
- Surgery: In rare cases, your doctor may suggest a procedure like a lung transplant or lung volume reduction surgery, which removes damaged parts of your lungs.
If your flare is severe, your doctor may admit you to the intensive care unit (ICU.) This means that you’ll be more closely watched during your stay. Nurses will frequently check key signs of your health, like your oxygen rate, heart rate, and breathing rate.
After your symptoms improve, your doctor may move you to a step-down unit (SDU). You’ll be watched less closely than in the ICU, but you’ll still get more care than you would in a usual hospital room. Spending time in the SDU may make it less likely that you’ll need to return to the hospital after you go home.
Before You Go Home
How long you’ll need hospital care depends on many factors, including your symptoms, other health conditions you have, and the type of treatment that you’re given. But it’s different for everyone.
Once you improve enough to be discharged, ask your nurse or doctor:
- What medications should I take at home and when?
- Will I need a portable oxygen tank at home? If so, for how long?
- When do I need to follow up with my doctor?
- Will a nurse come and check on me at home?
- How can I get help paying for my prescriptions?
- Do I need physical therapy to build up my strength?
- What daily activities can I do or not do?
- What early signs should I look out for that my COPD is getting worse?
- Once I’m discharged, who can I call if I have a question?
If you smoke and need help to quit, ask about that, too. Smoking makes your COPD symptoms worse over time.
How to Be Prepared
Setting up an action plan ahead of time with your doctor can make a trip to the hospital less stressful. This plan can include:
- Daily actions to manage your COPD symptoms
- Steps to take if your symptoms to get worse
- Your vaccination records
- Your allergies
- A list of medications you take
- Details about other health issues you have
- Info about your height and weight
- Contact info for someone who can make decisions about your care if you’re not able to
- Where to find legal documents, like a copy of your medical power of attorney
The American Lung Association has a COPD action plan you can print out for free and bring to your next doctor visit.
Am I likely to be hospitalized again?
Hospital stays can be common when you live with COPD. To help prevent another flare-up:
- Follow up with your care. Keep all scheduled visits with your primary care doctor and with any COPD specialist.
- Take it easy. Give yourself time to rest and recover. It may be a while before you’re back to all your usual activities.
- Know your triggers so you can avoid them. Smoke, dust, heavily scented products, and extreme heat or cold temperatures are just a few things that can make COPD symptoms worse.
- Get support from your loved ones. Make sure your family and friends know the early signs of a flare and what to do if you have them.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
CDC: “Basics About COPD.”
Mayo Clinic: “COPD.”
American Lung Association: “COPD Trends Brief: Burden,” “COPD Action Plan and Management Tools,” “My COPD Action Plan,” “Prevent COPD Exacerbations or Flare Ups.”
American College of Emergency Physicians: “Chronic Obstructive Pulmonary Disease (COPD).”
COPD Foundation: “COPD in the Hospital and the Transition Back to Home.”
Critical Care Explorations, “The Impact of Step-Down Unit Care on Patient Outcomes After ICU Discharge.”
Annals of Medicine & Surgery: “Factors affecting length of hospital stay in chronic obstructive pulmonary disease patients in a tertiary hospital of Nepal: A retrospective cross-sectional study.”
