scholarly journals Prehospital emergency medical technicians can perform ultrasonography and blood analysis in prehospital evaluation of patients with chronic obstructive pulmonary disease: a feasibility study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giti Nadim ◽  
Christian B. Laursen ◽  
Pia I. Pietersen ◽  
Daniel Wittrock ◽  
Michael K. Sørensen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Insufficiency ◽  
Emergency Departments ◽  
Emergency Medical Technicians ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Emergency Medical ◽  
Short Period ◽  
Release Strategy

Abstract Introduction Crowding of the emergency departments is an increasing problem. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are often treated in the emergency departments for a very short period before discharged to their homes. It is possible that this treatment could take place in the patients’ homes with sufficient diagnostics supporting the treatment. In an effort to keep the diagnostics and treatment of some of these patients in their homes and thus to reduce the patient load at the emergency departments, we implemented a prehospital treat-and-release strategy based on ultrasonography and blood testing performed by emergency medical technicians (EMT) or paramedics (PM) in patients with acute exacerbation of COPD. Method EMTs and PMs were enrolled in a six-hour educational program covering ultrasonography of the lungs and point of care blood tests. During the seasonal peak of COPD exacerbations (October 2018 – May 2019) all patients who were treated by the ambulance crews for respiratory insufficiency were screened in the ambulances. If the patient had uncomplicated COPD not requiring immediate transport to the hospital, ultrasonographic examination of the lungs, measurements of C-reactive protein and venous blood gases analyses were performed. The response to the initial treatment and the results obtained were discussed via telemedical consultation with a prehospital anaesthesiologist who then decided to either release the patient at the scene or to have the patient transported to the hospital. The primary outcome was strategy feasibility. Results We included 100 EMTs and PMs in the study. During the study period, 771 patients with respiratory insufficiency were screened. Uncomplicated COPD was rare as only 41patients were treated according to the treat-and-release strategy. Twenty of these patients (49%) were released at the scene. In further ten patients, technical problems were encountered hindering release at the scene. Conclusion In a few selected patients with suspected acute exacerbations of COPD, it was technically and organisationally feasible for EMTs and PMs to perform prehospital POCT-ultrasound and laboratory testing and release the patients following treatment. None of the patients released at the scene requested a secondary ambulance within the first 48 h following the intervention.

scholarly journals Vascular changes in the retina in patients with chronic respiratory insufficiency

2014 ◽  
Vol 71 (12) ◽  
pp. 1132-1137
Author(s):  
Antoaneta Adzic-Zecevic ◽  
Biljana Milojko ◽  
Mirjana Janicijevic-Petrovic
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Blood Vessels ◽  
Pulmonary Disease ◽  
Bronchial Asthma ◽  
Respiratory Insufficiency ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Retinal Blood Vessels ◽  
Chronic Respiratory Insufficiency

Background/Aim. Chronic respiratory insufficiency is a pathological state which occurs as a result of respiratory system inability to maintain normal gas exchange between the outside air and circulating blood. For the purposes of human organism?s proper functioning, it is necessary that a certain amount of air in the lungs comes into contact with a certain amount of blood within a unit of time, so that an adequate hemoglobin oxygenation could be achieved. Then, hemoglobin from erythrocytes in the blood supply delivers oxygen to all the tissues and cells of the body including the eye. Direct impact of hypoxemia and hypercapnia on the wall of arterioles, venules and capillaries results in a severe vasodilatation along with the increased permeability of the walls causing clinically evident changes in the retina. The aim of this study was to determine the degree of ocular changes in retina with patients suffering from chronic respiratory insufficiency. Methods. A prospective study was conducted on 80 patients, 40 patients with respiratory failure and 40 patients with chronic obstructive pulmonary disease an and bronchial asthma (the control group). In all the patients direct and indirect ophthalmoscopy and fluoresceine angiography was performed. Clinically visible fundus and retina changes in patients suffering from chronic respiratory failure were categorized as mild (dilatation and retinal veins and arteries tortosion up to the mid-periphery), moderate (retinal hemorrhage) and severe (optic nerve edema, macular edema, superficial and deep retinal hemorrhages and venous occlusion). Results. In the patients suffering from respiratory insufficiency the changes in retinal blood vessels were found [in 18 (45%) mild, in 13 (32.5%) moderate, and in 9 (22%) severe], while in the patients with chronic obstructive pulmonary disease and bronchial asthma (without respiratory insufficiency) no changes were recognized. Conclusion. The results of this study indicate the need for ophthalmologic examination in patients with chronic respiratory insufficiency. It is important to recognize, identify and quantify the changes on retinal blood vessels which are clinically significant. It is necessary to provide their monitoring and to prescribe proper therapeutic treatment in order to preserve visual functions.

scholarly journals Recent advances on animal models related to chronic obstructive pulmonary disease

2019 ◽  
Vol 02 (03) ◽  
pp. 93-104
Author(s):  
Shan Jiang ◽  
Nabjian Mohammadtursun ◽  
Jian Qiu ◽  
Qiuping Li ◽  
Jing Sun ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Animal Model ◽  
Animal Models ◽  
Pulmonary Disease ◽  
Economic Burden ◽  
Public Health Problem ◽  
Chronic Obstructive ◽  
Important Public Health Problem ◽  
Obstructive Pulmonary Disease ◽  
Short Period

Chronic obstructive pulmonary disease (COPD) has become an important public health problem in the world. According to reports, COPD ranks fourth in the global cause of death, causing a serious economic burden on society. The pathogenesis of COPD is complex, making it difficult to simulate the pathological changes and clinical features of COPD. Moreover, the COPD animal model has an irreplaceable role in the study of etiology, pathology and treatment. It is worth noting that the risk factors for chronic obstructive pulmonary disease persist, and the economic burden of global chronic obstructive pulmonary disease is expected to continue to increase in the coming decades. Establishing a standardized, a clinically realistic COPD animal model has always been a research direction that scholars are keen on. Therefore, it is essential to establish an economical animal model. The establishment of a suitable animal model can accurately simulate the pathological features of human chronic obstructive pulmonary disease and help to develop effective interventions and treatments in a short period of time. This review integrates the experimental animal species selected in the animal models used in COPD studies. Subsequently, different methods and mechanisms for establishing animal models were summarized according to different modeling factors. Finally, the criteria for evaluating existing animal models are discussed. It is hoped that the summary of this paper will guide the establishment of relevant animal models for future COPD research.

scholarly journals Get with the guidelines: management of chronic obstructive pulmonary disease in emergency departments in Europe and Australasia is sub‐optimal

2020 ◽  
Vol 50 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Anne‐Maree Kelly ◽  
Oene Van Meer ◽  
Gerben Keijzers ◽  
Justina Motiejunaite ◽  
Peter Jones ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Emergency Departments ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Get With The Guidelines

Exercise causes blood glutathione oxidation in chronic obstructive pulmonary disease: prevention by O2 therapy

1996 ◽  
Vol 81 (5) ◽  
pp. 2199-2202 ◽  
Author(s):  
José Viña ◽  
Emilio Servera ◽  
Miguel Asensi ◽  
Juan Sastre ◽  
Federico V. Pallardó ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Disease Prevention ◽  
Pulmonary Disease ◽  
Oxygen Therapy ◽  
Reduced Glutathione ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Short Period ◽  
Glutathione Oxidation

Viña, José, Emilio Servera, Miguel Asensi, Juan Sastre, Federico V. Pallardó, José A. Ferrero, JoséGarcı́a-de-la-Asunción, Vicente Antón, and Julio Marı́n. Exercise causes blood glutathione oxidation in chronic obstructive pulmonary disease: prevention by O2therapy. J. Appl. Physiol. 81(5): 2199–2202, 1996.—The aim of the present study was to determine whether glutathione oxidation occurs in chronic obstructive pulmonary disease (COPD) patients who perform exercise and whether this could be prevented. Blood glutathione red-ox ratio [oxidized-to-reduced glutathione (GSSG/GSH)] was significantly increased when patients performed exercise for a short period of time until exhaustion. Their resting blood GSSG/GSH was 0.039 ± 0.008 (SD) ( n = 5), whereas after exercise it increased to 0.085 ± 0.019, P < 0.01. Glutathione oxidation associated with exercise was partially prevented by oxygen therapy (resting value: 0.037 ± 0.014, n = 5; after exercise: 0.047 ± 0.016, n = 5, P < 0.01). We conclude that light exercise causes an oxidation of glutathione in COPD patients, which can be partially prevented by oxygen therapy.

scholarly journals The Chinese version of the Severe Respiratory Insufficiency questionnaire for patients with chronic hypercapnic chronic obstructive pulmonary disease receiving non-invasive positive pressure ventilation

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017712 ◽  
Author(s):  
Rongchang Chen ◽  
Lili Guan ◽  
Weiliang Wu ◽  
Zhicong Yang ◽  
Xiaoying Li ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Factor Analysis ◽  
Pulmonary Disease ◽  
Respiratory Insufficiency ◽  
Content Validity ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive

ObjectivesThe Severe Respiratory Insufficiency (SRI) questionnaire is the best assessment tool for health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) receiving non-invasive positive pressure ventilation (NIPPV). This study aimed to translate the SRI Questionnaire into Chinese and to validate it.DesignProspective validation study.Setting and participantsA total of 149 participants with chronic hypercapnic COPD receiving NIPPV completed the study.MethodsThe SRI questionnaire was translated into Chinese using translation and back-translation. Reliability was gauged using Cronbach’s α coefficient. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to assess construct validity. Content validity was confirmed by evaluating the relationship between the score of each item and the total score of the relevant subscale.ResultsCronbach’s α coefficients for each subscale and summary scale were above 0.7. Using EFA, one factor was extracted from the anxiety and summary scales and two factors were extracted from the remaining six subscales. Based on the EFA results, subsequent CFA revealed a good model fit for each subscale, but the extracted factors of each subscale were correlated. Content validity was confirmed by the good relationship between the score of each item and the total score of the relevant subscale.ConclusionThe Chinese version of the SRI questionnaire is valid and reliable for patients with chronic hypercapnic COPD receiving NIPPV in China.Trial registration numberNCT02499718.

Sign in / Sign up

Export Citation Format

Share Document