A selection of resources

COPD

Exacerbation

Be sure of the diagnosis.

Become more familiar with Bipap.

When to give antibiotics?

COPD

The guidelines

The NICE guidelines aren't particularly specific or helpful but they do have a 2 page summary of antibiotic therapy in COPD exacerbation.

Two suggested scoring systems are DECAF and BAP-65.

British thoracic society has a detailed guide to NIV.

COPD

The FOAM Resources

Some of the finest free to access resources out there

LITFL

Simple bullet point guide to NIV

IBCC

The internet book of critical care provides detailed breakdown of unwell patients with COPD

IBCC

A very detailed look at bipap, for a simpler guide I would use the EMJ review below

Some useful papers

Cochrane review of antibiotics

This systematic review suggests that benefit is largely limited to those with severe exacerbations.

Cochrane review of steroids

This systematic review indicates fairly definitively that although steroids very effective, the side effect frequency is high (NNH 4-10).

Good reviews of NIV

EMJ review has a simple review of NIV and the evidence and thorax review is more detailed.