Janet Boehm EdD, MS, RRT
Director, Clinical Education
Youngstown State University
Youngstown, OH

Richard Branson, MS, RRT, FAARC
Associate Professor of Surgery
University of Cincinnati College of Medicine Cincinnati, OH

Richard Kallet, MSc RRT, FAARC
Clinical Projects Manager
University of California
Cardiovascular Research Institute
San Francisco, CA

Donna Hamel, RRT, FAARC
Clinical Research Coordinator
Duke University Health Systems
Raleigh-Durham, NC

Neil MacIntyre, MD, FAARC
Medical Director of Respiratory Services
Duke University Medical Center
Durham, NC

Tim Myers, BS, RRT-NPS
Pediatric Respiratory Care
Rainbow Babies and Children’s Hospital
Cleveland, OH

Tim Op’t Holt, EdD, RRT, AEC, FAARC
Professor, Department of Respiratory Care
and Cardiopulmonary Sciences
University of Southern Alabama
Mobile, AL

Ruth Krueger Parkinson, MS, RRT
Protocol/ PI Coordinator
Sioux Valley Hospital
Sioux Valley, SD

Helen Sorenson, MA, RRT, FAARC
Assistant Professor, Dept. of Respiratory Care
University of Texas Health Sciences Center
San Antonio, TX

Managing COPD Exacerbations in the Hospital and Home
By David Vines, MHS, RRT, FAARC and Sandra Adams, MD, MS

Chronic obstructive pulmonary disease (COPD) primarily results from inhalation of noxious gases which create an airflow limitation. This airflow limitation is not completely reversible. The severity of this disease is classified depending on the degree of airflow limitation that exists. The patients with moderate to severe limitations have a higher occurrence of COPD exacerbations. Acute COPD exacerbations are identified by an increase in the patient’s dyspnea, cough, and production and/or purulence of their sputum. COPD exacerbations affect the patient’s quality of life, morbidity, and mortality. They also place a large financial burden on the healthcare system. The treatment of an exacerbation involves the use of short-acting bronchodilators, oral or intravenous corticosteroids, antibiotics, oxygen therapy, noninvasive positive pressure ventilation, and secretion removal. Based on the patient’s severity, history, and symptoms they may be treated in the home or hospital setting. The prevention of more exacerbations involves smoking cessation, vaccinations, long-acting bronchodilators, inhaled corticosteroids, patient education, and outpatient pulmonary rehabilitation. The article is a review of the current recommendations and evidence related to the care of COPD patients with acute exacerbations. To lessen the burden of this disease it is important for healthcare providers to understand these current recommendations and guidelines.

Panel Discussion: Applying Comprehensive Chronic Care to Impact Acute Exacerbations of COPD
Moderator: Sandra Adams, MD, MS
Panelists: Sidney Braman, MD, FACP, FCCP
Susan Blonshine RRT, RPFT, FAARC, AE-C
Nicola Hanania, MD, MS, FCCP, FRCP(C), FACP

COPD exacerbations represent a significant burden to both patients and healthcare providers. As with other medical conditions, preventive strategies can help avoid the need for acute care situations. An action plan that incorporates patient education, ready access to medications, and medical support can go far to prevent exacerbations, but there are challenges in implementing these measures. We have invited a panel of experts to discuss some of the advantages and barriers to the successful management of the patient with COPD.

All CE Modules have been renewed for 2009