Question

A 72-year-old woman with COPD presents to the emergency department with increased dyspnoea, wheeze and purulent sputum over 3 days. She is afebrile, saturations are 90% on room air and chest x-ray shows no pneumonia. What is the most appropriate initial management?

Accepted Answer

Give frequent inhaled salbutamol via metered-dose inhaler with spacer, add a short course of oral prednisone and prescribe antibiotics

Answer

Start high-dose inhaled corticosteroid alone

Answer

Admit to ICU for immediate intubation and ventilation

Answer

Start long-acting bronchodilator therapy only and review in 2 weeks

Answer

Withhold antibiotics because she is afebrile and treat with steroids only

Practice question

A 72-year-old woman with COPD presents to the emergency department with increased dyspnoea, wheeze and purulent sputum over 3 days. She is afebrile, saturations are 90% on room air and chest x-ray shows no pneumonia. What is the most appropriate initial management?