Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute exacerbation of COPD characterized by increased dyspnea, cough, and sputum production. Sputum is noted to be clear/mucoid, lacking purulence, suggestive of viral or eosinophilic etiology. No fever or systemic signs of bacterial infection. Symptoms preceded by recent URI symptoms. Patient reports increased use of rescue inhalers with suboptimal relief.
Clinical Examination Findings
General: Patient in mild respiratory distress, speaking in short sentences. HEENT: Oropharynx clear, no tonsillar exudate. Lungs: Bilateral expiratory wheezing, prolonged expiratory phase, no focal consolidation. Heart: Tachycardic, regular rhythm, no murmurs or S3/S4. Extremities: No peripheral edema or cyanosis. O2 saturation stable on room air.
Treatment Protocol
1. Systemic corticosteroids (e.g., Prednisone 40mg daily for 5 days) to address eosinophilic inflammation. 2. Short-acting bronchodilators (SABA/SAMA) via nebulizer or MDI. 3. Consider inhaled corticosteroids (ICS) escalation if not already on maintenance. 4. Supportive care: hydration and rest. No antibiotics indicated at this time given lack of purulent sputum or systemic inflammatory markers.