In many cases, these patients are discharged shortly after admission following a brief treatment consisting of broncholytics and in some cases corticosteroids and antibiotics. Patients with acute exacerbations in chronic obstructive pulmonary disease (AE-COPD) are frequently transported to the emergency room of the hospital. The usual approach: “ To transport the patient to the hospital”, where all acutely ill patients are consistently transported to hospital for further care is challenged by increasing costs because of an ageing population, the increased incidence of chronic diseases, the socio-economic disparity associated with most chronic diseases and the ensuing crowding of the emergency departments. The emergency medical system (EMS) is a critical first link in the chain of survival and has the capacity for the early management of acutely ill patients. None of the patients released at the scene requested a secondary ambulance within the first 48 h following the intervention. 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. In further ten patients, technical problems were encountered hindering release at the scene. Twenty of these patients (49%) were released at the scene. Uncomplicated COPD was rare as only 41patients were treated according to the treat-and-release strategy. During the study period, 771 patients with respiratory insufficiency were screened. We included 100 EMTs and PMs in the study. The primary outcome was strategy feasibility. 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. 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. 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. MethodĮMTs and PMs were enrolled in a six-hour educational program covering ultrasonography of the lungs and point of care blood tests. 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. It is possible that this treatment could take place in the patients’ homes with sufficient diagnostics supporting the treatment. 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. Crowding of the emergency departments is an increasing problem. MHRA 'ISTAT', All Acronyms, 10 July 2022, Bluebook All Acronyms, ISTAT (Jul. ISTAT, All Acronyms, viewed July 10, 2022, MLA All Acronyms. Retrieved July 10, 2022, from Chicago All Acronyms. Facebook Twitter Linkedin Quote Copy APA All Acronyms.
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