Abstract
BackgroundIn Denmark emergency medical technicians transport patients with acute COPD exacerbations to the nearest emergency department. From a clinical and economic perspective, this transport and assessment at the hospital may be inconvenient if the patient is immediately discharged from the emergency department. We established an emergency technical technicians point-of-care diagnostics and treatment program of patients with COPD with use of ultrasound and blood analysis. Patients' perspectives on treatment at home and sense of security are important to qualify clinical practice at home with patients with acute exacerbation.Aim and objectivesTo explore patient's and relatives' experience of treatment at home during emergency calls due to COPD in exacerbation and to investigate their attitude to avoid hospitalization as well as experience of stress during point-of-care diagnostics in their own home.MethodA qualitative study comprising semi-structured interviews with 16 patients carried out from April 1st, 2019 to March 31st, 2020 in Denmark. Data was analysed inspired by Malteruds’ text condensation and informed by Critical Psychology with first person perspective focusing on the patient's views on point-of-care diagnostics and treatment of their COPD in acute exacerbation.ResultsThe interviews revealed that in order to ensure an experience of quality in the assessment and treatment of patients in their own homes, it was important that the ambulance staff showed great safety and experience in the use of the technical equipment and treatment of dyspnea. It was also of importance that the patients felt confident that their general practitioner followed up on the home treatment initiated.ConclusionPatients’ perspectives showed that point-of-care diagnostics and treatment of acute COPD in exacerbation was considered a qualitative offer by the patients and their relatives. At the same time, it was crucial that the emergency medical technicians showed experience and safety in handling shortness of breath as well as the technical equipment.Trial registration: Approved by the Danish Data Protection Agency Project-ID: 20/24845.
Highlights
Chronic obstructive pulmonary disease (COPD) is considered one of the leading causes of mortality worldwide [1, 2]
Patients’ perspectives showed that point-of-care diagnostics and treatment of acute COPD in exacerbation was considered a qualitative offer by the patients and their relatives
It was crucial that the emergency medical technicians showed experience and safety in handling shortness of breath as well as the technical equipment
Summary
Chronic obstructive pulmonary disease (COPD) is considered one of the leading causes of mortality worldwide [1, 2]. In Denmark, emergency medical technicians (EMT) transport patients with acute COPD exacerbations to the emergency department (ED) [6]. If other comorbidities are excluded and the patient responds to the initial treatment, the patient will typically be discharged after a short evaluation within 24 h of admission [8] This transport and assessment at the hospital may be inconvenient for the patients’ and relatives’ life quality, wellbeing, and pose a risk for nosocomial infection. In Denmark emergency medical technicians transport patients with acute COPD exacerbations to the nearest emergency department. From a clinical and economic perspective, this transport and assessment at the hospital may be inconvenient if the patient is immediately discharged from the emergency department. Patients’ perspectives on treatment at home and sense of security are important to qualify clinical practice at home with patients with acute exacerbation
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