*4.3.2 Duration of early signs and symptoms occurrence before cannot breathe*

The duration of early signs and symptoms occurrence before cannot breathe able start from immediately to 1 week. It is different individually that similar to time of early signs and symptoms occurrence.

Although healthcare professionals especially the doctor can know all characteristics of warning signs and prodromal symptoms from COPD patients, they need to assess all signs and symptoms from the patients' caregivers as well. Because some patients cannot tell their all signs and symptoms by themselves. Their caregivers able to help them to inform or encourages the patients to notice those signs and symptoms more clearly. When the clinicians can combine all data from the patients and their caregivers successfully which the data can be gathered early in the onset of exacerbation, it is even better to help the patients manage those signs and symptoms early. As a result, the level of PET dose not decrease rapidly due to each exacerbation which induces the patients to die quickly. The clinicians must also plan for manage those early warning signs and prodromal symptoms early and communicate appropriate methods to manage them with COPD patients and their families by providing the management methods both medication and non-medication treatments or the methods that the patients could learn on their own from previous exacerbation events.

According to early warning signs and prodromal symptoms of AECOPD patients, the characteristics of it can be described in **Figure 1** as follow.
