Management of COPD exacerbations in hospital emergency departments.

Introduction: Emergency departments (EDs) play a crucial role in managing exacerbation of COPD (ECOPD). However, there is currently no standardization of management criteria for ECOPD within the Spanish healthcare system. This document aims to outline the management of ECOPD in EDs in the context of 2025, serving as a guide for healthcare professionals working in emergency services.

Areas covered: Various aspects of the management of ECOPD in EDs are covered in this article, including severity classification, treatments (both pharmacological and nonpharmacological), criteria for hospital admission and discharge from the ED, treatment at discharge, palliative care, and management of frail patients.

Expert opinion: The authors, who are members of the Spanish Society of Emergency Medicine (SEMES), emphasize the importance of classifying the severity of the episode and the patient characteristics to tailor care to each individual. The authors also highlight the value of biomarkers, the appropriate use of ventilatory therapies for ECOPD patients, the importance of proper antibiotic management, and the establishment of clear referral protocols to prevent patients from feeling lost in the healthcare system. Finally, the need to personalize post-discharge treatments is underscored to enhance continuity of care and improve health outcomes.