You and your healthcare practitioner should develop a written action plan for flare-ups (exacerbations). This plan may include:

  • Using more medicines to relax and open your airways (bronchodilators) and using them more frequently
  • Adding an inhaled corticosteroid (ICS) to your care plan. Or, increasing the dose if you already take one.
  • Adding a new bronchodilator.
  • Using antibiotics.
  • Using oral corticosteroids (OCS) for 3-14 days to reduce inflammation.
  • Eating properly and drinking plenty of fluids.

Download Your Action Plan for Exacerbations (Flare-ups)  as a PDF.

Action plan: Should you go to the hospital?

Most people can follow their action plans and deal with flare-ups at home. However, some people may need to go to the hospital when their symptoms get worse. These include people who

  • Are severely ill
  • Are on chronic oxygen therapy
  • Have had respiratory failure in the past

To assess the severity of a flare-up, patients with Alpha-1 COPD flare-ups may need

  • A chest examination
  • An X-ray (to rule out pneumonia)
  • Arterial blood gas tests to check oxygen and carbon dioxide levels

Action plan: When to call your healthcare practitioner

Call your health care provider within 24 hours if you:

  • Need to use your rescue inhaler or nebulizer more often, and using them doesn’t help you breathe better.
  • Have more mucus, and it’s thicker, has a different color, and smells.
  • Have swollen ankles, even after a night of sleeping with your feet up.
  • Wake up feeling short of breath more than once a night.
  • Feel tired for longer than just a day.
  • Have a fever for more than a day.

Action plan: Symptoms that say go to the Emergency Department

If you have these symptoms, call 911 or go right to the emergency room:

  • Disorientation, confusion, slurring of speech, or sleepiness during an acute respiratory infection
  • Loss of alertness, or two or more of the following:
    • A sudden increase in shortness of breath even when you’re at rest
    • Having to use your upper chest and neck muscles (accessory muscles) to breathe
    • Big increase or decrease in respiratory rate
    • Big increase in heart rate
  • Any severe shortness of breath, chest pain, or other symptoms that makes you fear for your ability to survive.

What not to do when you have a flare-up

There are many things you can do at home to treat signs and symptoms. But don’t

  • Smoke.
  • Take codeine or any other cough medicine.
  • Wait more than 24 hours to contact your healthcare practitioner if symptoms continue.

Remember: Your symptoms won’t go away if you ignore them. Watch your symptoms and follow your action plan to make sure flare-ups don’t turn into something worse.

For more in-depth information on this topic, please visit the Big Fat Reference Guide (BFRG). If you are enrolled in AlphaNet’s Subscriber Portal, you can access the BFRG here.

Download Your Action Plan for Exacerbations (Flare-ups)  as a PDF.


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