COPD exacerbation assessment (adult UK pathway)
A source-linked educational visual of adult COPD exacerbation assessment, controlled oxygen, treatment and escalation based on NICE and BTS guidance.
Important safety note
This visual algorithm is an educational representation of published UK clinical guidance and is not a substitute for clinical judgement, local protocols, senior/specialist advice, or the original guideline. Verify current guidance before clinical use.
Scope and source
- Scope
- Adults with an acute exacerbation of COPD in UK emergency and acute-care services.
- Jurisdiction
- UK
- Primary guidance
- NICE NG115: Chronic obstructive pulmonary disease in over 16s
- Guidance last updated
- 2019-07-26
- Clinical reference reviewed
- 2026-09-08
- Review due
- 2027-03-08
Interactive clinical algorithm
This source-backed visual algorithm is available in the interactive page experience. Open the original guidance and the node notes before clinical use.
How to read this visual
- Read across the columns for the phases of the pathway; the swimlanes are who acts — Emergency team, Investigations and monitoring, Respiratory support and specialist care.
- Bold marks the dose, threshold or time limit that decides the next step; the rest of a label is context.
- Start with ABCDE and controlled oxygen before the treatment branch.
- Use notes to distinguish hypercapnic respiratory failure from uncomplicated exacerbation.
Clinical notes
- Target saturations, blood-gas interpretation and NIV decisions must follow local policy and senior review.
- Consider pneumothorax, pulmonary embolism, pneumonia and heart failure where clinically indicated.
Sources
- NICE NG115: COPD in over 16s (NICE; 2019-07-26)
- BTS guideline for oxygen use in adults (British Thoracic Society; 2017-10-01)
Open an editable reference copy
Create a personal educational copy. Verify the original guidance before clinical use.