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COPD Basics and Flare-Up Warning Signs

Learn what COPD is, what a pulse oximeter measures, the warning signs of a flare-up, and when to call 911.

What COPD is

COPD stands for chronic obstructive pulmonary disease. It is a long-term lung disease that makes it hard to breathe. It usually gets worse slowly over time.

COPD includes two main problems. In emphysema, the tiny air sacs in the lungs are damaged, so it is harder to move air out. In chronic bronchitis, the airways stay irritated and swollen and fill with thick mucus. Many people have some of both.

Common signs include:

  • A cough, often with a lot of mucus
  • Shortness of breath during everyday tasks
  • Wheezing or chest tightness

In the United States, smoking is the main cause. There is no cure, but treatment can help you feel better and stay active. Quitting smoking is the most important step for people who smoke. Other treatments may include medicines, pulmonary rehabilitation (a program that teaches breathing skills and healthy activity), vaccines, and oxygen if your blood oxygen is low.

What a pulse oximeter measures

A pulse oximeter is a small clip that goes on your fingertip. It shines a light through your finger to estimate how much oxygen your red blood cells are carrying. There are no needles.

The American Lung Association says a good reading is usually over 90 to 92 percent. Ask your clinician what number is right for you.

Readings can be wrong or jump around. Things that can affect them include:

  • Cold hands or poor blood flow
  • Darker skin
  • Dark, long or artificial nails, or dirty fingers
  • Current smoking

A single number should not be used alone to judge how you are doing. Tell your clinician about readings that seem off.

Warning signs of a flare-up

A flare-up is when your symptoms suddenly get worse. It may last two days or more. Signs can include:

  • More coughing
  • Changes in the color, thickness or amount of mucus
  • More shortness of breath, or trouble taking a deep breath
  • Wheezing or noisy breathing
  • Trouble sleeping
  • Feeling more tired than usual

To lower your risk, stay away from smoke and strong fumes, wash your hands often, avoid people who are sick, and ask your doctor which vaccines you need.

Make an action plan with your clinician

A COPD action plan is a written plan you make with your clinician. The American Lung Association's plan uses three zones:

  • Green: your usual day. Keep taking your medicines and using oxygen as prescribed.
  • Yellow: you have more symptoms than usual. Follow the steps in your plan, and call your clinician if you do not get better.
  • Red: severe symptoms. Get help right away.

Keep your plan where you and your family can find it.

When to call 911

Call 911 or get medical care right away if you have:

  • Severe shortness of breath, even at rest
  • Trouble breathing so bad that you cannot do any activity or cannot sleep
  • Chest pain
  • Blue or gray lips, fingertips or nails
  • Coughing up blood
  • Confusion or feeling very drowsy
  • Fever or shaking chills

For some people with COPD, the Willow Harbor at Home device can be a pulse oximeter that sends readings by itself over a cellular connection. The care team reviews readings and follows up during business hours. It is not an emergency service, so in an emergency, call 911.

This guide is general information, not medical advice. Talk with your doctor about your own care.

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