COPD Symptoms: Calling Your Healthcare Provider vs. 911

A COPD exacerbation, or more simply a "flare-up," happens when COPD symptoms worsen and the lungs become inflamed and irritated. This is usually caused by a viral infection in the lungs, but it can also happen if you inhale an irritating substance like an allergen or air pollution.

COPD exacerbations can be very severe and sometimes life-threatening, requiring you to be hospitalized. Because they can begin suddenly over the course of a few hours to days, it's important to be prepared with an emergency action plan so that you can act quickly and decisively to get the help you need.

This article discusses why and when you should call 911 for your COPD symptoms. It also covers several tips that may help prevent a COPD flare-up, along with how you can prepare by creating an emergency action plan.

An older couple video chatting with their doctor
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When to Call 911

According to a study published in the American Journal of Epidemiology, for each of the 1,107 people with COPD who were studied, there were an average of 1.53 exacerbations per year. Nearly 22% of the exacerbations were considered severe, and 39 people died from related complications.

The severity of COPD exacerbations can be classified into three groups:

  • Mild: Exacerbations that can be self-managed at home without the need for corticosteroids or antibiotics
  • Moderate: Exacerbations that require a healthcare provider's visit and/or treatment with oral corticosteroids or antibiotics
  • Severe: Exacerbations that require hospitalization

You can reduce your risk of life-threatening COPD exacerbations through prevention, early detection, and prompt treatment when symptoms arise. Don't hesitate to call 911 if you develop any of the following:

Fatigue, shortness of breath, difficulty waking up in the morning, and several other symptoms are common in COPD—even in people who aren't having an exacerbation.

The key to knowing when to call 911 is paying attention to when symptoms are getting worse. You may find it helpful to track your symptoms regularly in a journal and note how they affect you. That way, if a symptom gets worse, you will be less likely to second-guess yourself.

When to Call Your Healthcare Provider

If you have never had a severe exacerbation before, you might feel unsure about whether you should call 911 or reach out to your healthcare provider.

Although not everyone needs medical attention for their COPD exacerbation, it's best not to take chances. If you develop new or worsening COPD symptoms that you think could be an emergency, call 911 right away.

The following list includes symptoms that should prompt you to call your healthcare provider:

  • A cough that becomes more frequent or feels deeper
  • Sputum that changes color or increases in volume
  • Increased shortness of breath, or shortness of breath upon awakening
  • Needing to elevate your head or use more pillows in order to sleep
  • Increased wheezing
  • Frequent morning headaches, which could be a sign of hypercapnia—an increased level of carbon dioxide in the blood
  • A fever, generally over 101 degrees
  • Flu symptoms, such as a fever, body aches, and sore throat
  • Swelling in your legs, especially if it is not relieved with elevation
  • Anxiety or restlessness
  • Inability to walk as far or take as many stairs as you ordinarily could
  • Increased need for "breakthrough" breathing treatments
  • Increasing fatigue or weakness

You should be able to connect to your healthcare provider or COPD care team whenever you feel the need. Call your healthcare provider's office and ask for the best phone number to reach your practitioner quickly. This contact information should be included in your emergency action plan.


Don't wait for your COPD symptoms to become life-threatening to seek medical advice. If you think your new or worsening symptoms are an emergency, call 911—even if you aren't sure. For symptoms that are mildly uncomfortable and don't interfere with your breathing, call your healthcare provider.

How to Create an Emergency Action Plan

Exacerbations are not an exception with this disease—you will more than likely have one at some point. Considering that COPD is the third leading cause of death worldwide, it is essential to have an emergency action plan (EAP) prepared well before you need it.

An emergency action plan is a set of step-by-step instructions that you should follow at the first sign of a COPD exacerbation. Everyone is different and has different needs. Your EAP should be specifically tailored to your needs with the help of your healthcare provider.

Items you should consider adding to your EAP include:

  • Your healthcare provider's name, phone number, and office address
  • A list of your prescriptions along with where you get them filled
  • When and how often you should take your short acting brochodilator or other prescription medications
  • A list of any other health conditions you have that first responders should know about
  • Contact information for loved ones in the area

The American Lung Association also has a COPD action plan that you can print here and bring with you to your next practitioner's visit. Ask your provider what they would add or change for your specific needs.

Take time to discuss your EAP with your family members and loved ones and make sure they have a copy. At the top of each copy, include a list of symptoms that should prompt them to call your healthcare provider along with symptoms that mean they should call 911.

Keep your emergency action plan in a prominent place in your home where you can easily find it—for example, on your refrigerator. You may also want to keep a copy on each floor of your home, in your car, and in your wallet so that there is always one nearby.

Tips for Preventing an Exacerbation

Although you can prepare for COPD exacerbations, you can't always prevent them.

Nonetheless, prevention is integral to COPD management, and can reduce how frequently you have exacerbations and how severe they become.

The following tips may help prevent a COPD exacerbation:

  • Review your emergency action plan often and follow it closely
  • Use the Air Quality Index to monitor the air where you live, and stay inside when pollutant levels are high
  • Quit smoking and talk to your healthcare provider if you need help quitting
  • Avoid being around others who are sick with a contagious illness
  • Get the flu vaccine every year
  • Talk to your practitioner about medications that may help prevent exacerbations
  • Wash your hands well and often
  • Drink plenty of water—at least six to eight glasses of water per day

Finally, don't underestimate the benefits of a healthy diet with lots of variety. If you are taking long-term steroids, you may need more calcium since steroids decrease calcium absorption. Ask your healthcare provider if a calcium supplement is right for you—preferably a supplement with vitamin D to help with absorption.


New or worsening COPD symptoms are cause for concern, and you should call 911 if you think your symptoms are an emergency. Detecting exacerbations early and getting treatment promptly can reduce your risk of a life-threatening exacerbation.

Take action to prevent exacerbations; every person with COPD should prepare an emergency action plan tailored to their needs. This should include information about when to call 911, along with step-by-step instructions to follow as soon as an exacerbation begins.

A Word From Verywell

COPD can feel like a rollercoaster ride of ups and downs, and there will likely be times when you feel that all is well and the ride is smooth. Use this time to journal your symptoms, review your EAP to ensure it stays up to date, and find new ways to reduce COPD fatigue in your everyday life. Embrace the moments when your COPD feels calm, but don't let your guard down. Staying prepared can save your life.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Sato M, Chubachi S, Sasaki M, et al. Impact of mild exacerbation on COPD symptoms in a Japanese cohortInt J Chron Obstruct Pulmon Dis. 2016 Jun;11(1):1269-1278. doi:10.2147/COPD.S105454

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By Deborah Leader, RN
 Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD.