CuraRN

Chronic Obstructive Pulmonary Disease (COPD)

Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.

EMS etiologies

Setting: ER

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by long-term respiratory symptoms, persistent airflow limitation, and chronic inflammation of the airways. The 2 primary types of COPD are: chronic bronchitis and emphysema.

• Emphysema is characterized by the destruction of the alveolar walls, leading to enlarged airspaces and impaired oxygen exchange.
• Chronic bronchitis involves persistent inflammation and mucus production in the bronchi, resulting in a productive cough for at least three months over two consecutive years.

COPD is often caused by tobacco smoking, which is the leading risk factor. Other causes include exposure to indoor and outdoor air pollution, occupational dust and chemicals, and genetic factors. In developing countries, the use of biomass fuels for cooking and heating also contributes significantly to the disease.

Clinical Presentation:

The hallmark symptoms of COPD include:

• Shortness of breath (dyspnea), which worsens over time, especially during physical activity.
• Chronic cough, often accompanied by mucus production (phlegm).
• Wheezing and chest tightness.

Treatment Modalities:

While COPD is incurable, it is both preventable and treatable. The main goals of treatment are to slow disease progression, manage symptoms, and improve quality of life. Key treatment strategies include:

1. Pharmacological Treatments:
   • Inhaled bronchodilators (e.g., beta-agonists, anticholinergics) to relieve symptoms and improve airflow.
   • Inhaled corticosteroids to reduce airway inflammation, particularly in patients with frequent exacerbations.
   • Long-term oxygen therapy for patients with severe hypoxemia.
   • Vaccinations (e.g., influenza and pneumococcal vaccines) to prevent respiratory infections that can worsen COPD.
2. Surgical Interventions:
   • Lung volume reduction surgery or lung transplantation may be considered in advanced cases of COPD.

During exacerbations, additional treatments such as corticosteroids, antibiotics, and hospitalization may be required.