Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute worsening of baseline respiratory symptoms, exceeding day-to-day variability. Reports increased dyspnea, increased sputum volume, and change in sputum character (purulence). Denies fever, chest pain, or hemoptysis. Anthonisen criteria met for bacterial exacerbation (Type I/II).
Clinical Examination Findings
General: Patient appears in mild respiratory distress, tachypneic at rest. HEENT: No jugular venous distension. Respiratory: Use of accessory muscles noted. Auscultation reveals diffuse expiratory wheezing and coarse crackles, decreased breath sounds bilaterally. Cardiovascular: Tachycardic, regular rhythm, no murmurs or S3/S4. Extremities: No peripheral edema or cyanosis.
Treatment Protocol
1. Systemic corticosteroids (e.g., Prednisone 40mg daily for 5 days). 2. Antibiotic therapy (e.g., Azithromycin or Doxycycline) targeting common pathogens (S. pneumoniae, H. influenzae, M. catarrhalis). 3. Escalation of short-acting bronchodilators (SABA/SAMA). 4. Oxygen therapy to maintain SpO2 88-92%. 5. Monitor ABG and inflammatory markers.