A 67-year-old man with COPD presents with increased breathlessness, productive cough with green sputum, and mild wheezing. He has no fever or chest pain. What is the most appropriate action?

• A. Refer to GP
• B. Offer antibiotics
• C. Advise inhaled bronchodilator only
• D. No action needed

Answer: (A)

Recognize an acute COPD exacerbation. The combination of increased breathlessness and a productive, purulent (green) sputum suggests deterioration that benefits from medical assessment to decide on antibiotics, steroids if needed, and to optimize inhaled therapy, while also ruling out other causes like pneumonia. A clinician can measure oxygen levels, review inhaler technique, and adjust treatment promptly to prevent progression or hospitalisation. The absence of fever doesn’t rule out infection, but management should not be delayed for self-treatment. Referring to a GP ensures appropriate evaluation and therapy, which is the safest next step.