Managing exacerbations – the bad times

Long term conditions: Man coughing

With COPD, there will be times that your condition is worse - you have extra symptoms, your breathlessness increases and you need more help (we call this exacerbation or a 'flare up'). You may also get chest infections which will make your symptoms worse. 

You can reduce the number of exacerbations you have by keeping active, eating well, using your medication as directed and having vaccinations such as the flu jab.   

If you are experiencing a 'flare up' or if you think you have a chest infection, it is important that you contact the COPD team or your GP immediately. The COPD team will be able to assess you and speak to your GP about suggested treatments, such as oral steroids and/or antibiotics. 

Most people can be treated at home if they have an exacerbation, but some will need to go into hospital. The decision about whether to go into hospital depends on factors such as:

  • how bad the exacerbation is
  • what your COPD is normally like
  • general health
  • how well you would be able to cope at home. 

The COPD team and your GP should look at your individual circumstances, when making a decision about what is suitable for you. If it is possible to manage your exacerbation at home, this will be accommodated. 

You may want to ask your GP or COPD nurse some of the following questions: 

  • Why do I get exacerbations and how should I treat them?
  • How can I stop getting them?
  • How do I know when to increase my bronchodilator medicine and by how much?
  • Can I have some oral steroids/antibiotics at home so that I can use them when I need them?
  • What vaccinations should I have?
  • Will I be able to make the decision or will someone make it for me?
  • How can I look after myself best and manage my illness?
  • What can I do if my local health service doesn't offer 'hospital-at-home' or 'assisted discharge' schemes?
  • When should I call a doctor/ambulance? 

If you are feeling unwell, experiencing an exacerbation or you need urgent advice, live in Greenwich and are known to the COPD team, you can call them on 020 8319 5381 from 7am to 7pm, seven days a week. Outside of these hours, call GRABADOC on 020 8319 3030, or if it is an emergency, please call an ambulance on 999.