Call 999 or go to A&E immediately if:
- you are finding it very hard to breathe. You might be gasping, choking or not able to speak
- your chest feels tight or heavy
- you have pain that spreads to your arms, back, neck and jaw
- your lips or skin are turning very pale or blue. On brown or black skin this might be easier to see on the palm of your hands
- you feel confused suddenly.
What is a COPD flare-up?
It’s normal for your COPD symptoms to change from day to day, but if your symptoms suddenly get worse you might be having a COPD flare-up. Flare-ups are sometimes called exacerbations.
Common symptoms of a COPD flare-up include:
- feeling more out of breath than usual
- coughing more than usual
- having more phlegm (sputum) than usual
- changes in the colour of your phlegm.
Other COPD flare-up symptoms include:
- wheezing more than usual
- feeling very tired (fatigued)
- finding it harder to exercise or be active
- feeling confused
- swollen ankles.
How are flare-ups treated?
Your COPD self-management plan should include personalised information about what to do if you think you’re having a flare-up.
At home
If you have less severe flare-up symptoms, you can treat them at home by following the advice on your COPD self-management plan. This usually involves:
- using a reliever inhaler (short-acting bronchodilator)
- taking medicines like oral steroids and antibiotics.
Rescue packs
Your healthcare professional might give you a short course of oral steroids or antibiotics to keep at home in case you have a flare-up. This is sometimes called a rescue pack.
If you’re given a rescue pack, your healthcare professional should explain when and how to take these medicines every time you have a review. It’s important that you know how to take your medicines properly because:
- Oral steroids can have side effects, especially if you’re taking higher doses.
- Taking antibiotics too often can cause antibiotic resistance, which means they stop working as well.
You should always tell your healthcare professional if you use your rescue pack to treat a COPD flare-up, so they can review your treatment and see if you need any changes to your medicines.
In hospital
You may need to be treated in hospital if you have a more severe flare-up.
If you’re treated in hospital, you might need tests to make sure you get the right treatment. This includes:
- a chest X-ray
- an electrocardiogram (ECG)
- blood tests, including a urea and electrolyte test
- a phlegm (sputum) sample.
Treatment in hospital can include:
- using a reliever inhaler (short-acting bronchodilator). In hospital you might take this through a nebuliser
- taking medicines like oral steroids and antibiotics
- non-invasive ventilation
- emergency oxygen
- theophylline.
Virtual wards
Virtual wards (sometimes called hospital at home) is a scheme where you will get hospital care for a COPD flare-up in your own home. You’ll get the same treatment from a specialist team, but they might use home visits or video calling.
If you’re interested in being treated on a virtual ward, speak to your healthcare professional. Together you can decide if this is the right choice for you.
What if I have multiple COPD flare-ups?
If you use three or more courses of oral steroids or antibiotics within a year, your healthcare professional should offer you a review to check that you are getting the right care and see if any additional treatment is needed.
When will I recover from a flare-up?
Recovery is different for everybody. COPD flare-ups usually last for seven to ten days, but it might take you longer to feel completely back to normal.
Most people fully recover within four to six weeks, but some people never feel as well as they did before their COPD flare-up. 1 in 5 people still have symptoms eight weeks after a COPD flare-up.
No matter whether you were treated at home or in hospital for a COPD flare-up, you should have a follow-up appointment with your GP when you feel better. This appointment helps to make sure your COPD is under control and prevent future COPD flare-ups.
We know COPD flare-ups can be scary. If you want to speak to somebody about your recovery, you can speak to a caring expert on our helpline. We also have a Health Unlocked forum where you can connect with other people who are living with COPD.
How can I prevent COPD flare-ups?
- Get help to stop smoking. If you smoke, stopping is the best way to prevent your COPD from getting worse and increase your life expectancy.
- Use a COPD self-management plan.
- Use the best COPD treatments for you and manage your COPD well.
- Check that you’re using your medicines properly. For example, if you use inhalers, check your inhaler technique.
- Get any vaccines that you’re offered, including your flu, COVID-19, RSV and pneumococcal vaccines.
- Ask your healthcare professional if you need to see a lung specialist or go to pulmonary rehabilitation (PR) classes.
It’s also a good idea to avoid anything that can make your COPD worse. You might call these COPD triggers. This includes:
- respiratory infections, like colds, flu, COVID-19 or RSV, pneumonia and chest infections
- indoor air pollution and allergies
- smoking and vaping
- outdoor air pollution
- pollen and hay fever
- cold weather
- hot weather.
We’re all different so get as much information as you can about your own condition – dust, pet hair, changes in temperature, air fresheners, hair spray and some foods can all irritate COPD.
For me its dust, scented candles and chocolate. Yes, I know. Chocolate. That’s just not fair!
Get support
Call our helpline for support with your condition. Get advice on your medicines, symptoms or travelling with a lung condition, or just call us to say hello.
