Diagnosing and treating COPD in the prehospital setting

Distinguishing between COPD and comorbidities, and scaling treatment and pharmacology to disease progression


Few shifts pass where we don’t care for a dyspneic patient with chronic obstructive pulmonary disease. COPD is included in our differential for almost all adult patients with shortness of breath. However, discerning between COPD exacerbation, acute decompensated CHF and pneumonia can be a daunting task without the luxury of x-rays and lab values.

Part 1: COPD prehospital treatment progression

In Part 1 of our COPD series, we’ll discuss the differential diagnosis of wheezing and review some basics of lung auscultation. Dr. Patrick outlines the typical prehospital treatment progression of COPD as the severity increases, with a review of pharmacology and physiology as well.

Part 2: COPD comorbidities and chameleons

In Part 2, Dr. Dickson and Dr. Patrick pick up where they left off on Part 1 and delve further into the complex differential of a dyspneic patient and discuss several of the “chameleons” that can masquerade as COPD.

If you treat every patient with a COPD history as COPD, you’ll be right most of the time, but eventually, you’ll run into disaster when that pneumothorax sneaks up and bites.

Most of our COPD patients are far from straight forward with multiple comorbidities. After completion of this series, you’ll run your next dyspnea call with a clear plan and loads of confidence.

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