Experience of an emergency mobile asthma treatment programme.
In order to reduce mortality and the need for hospital care for patients suffering from acute asthma, an emergency programme was set up. An ambulance crew, trained in coronary-pulmonary resuscitation was instructed in dealing with acute asthma and delegated to give 24 h treatment with bronchodilators (inhaled salbutamol and ipratropium bromide). If there was no, or only slight, improvement with this therapy, nurses (daytime) were delegated to give injections with corticosteroids (terbutaline and theophylline). Over a period of 2 years, 240 patients, 115 women and 125 men, were treated on 367 occasions. In 127 patients (53%), two or more treatments were given. The number of times treatment was given, as well as the proportion of females to males, increased the younger the patients were. Out of all the cases, more than 70% improved after treatment. On arrival, 21 patients (6%) were unconscious. After therapy, 15/21 patients (71%) survived. This may correspond to a similar reduction in mortality (population about 350,000 inhabitants), as it is unlikely that unconscious patients can survive without intensive care.
Löwhagen
O
O
Asthma and Allergy Centre, Sahlgrenska University Hospital, Göteborg, Sweden. olle.lowhagen@hjl.gu.se
Ekström
L
L
Holmberg
S
S
Wennerblom
B
B
Rosenfeldt
M
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000627:therapeutic use; D000552:Ambulances; D001249:Asthma / Q000188:drug therapy / Q000451:nursing / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation; D002648:Child; D003422:Critical Care; D004632:Emergency Medical Services; D005260:Female; D006301:Health Services Needs and Demand; D006323:Heart Arrest / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D009241:Ipratropium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013726:Terbutaline / Q000008:administration & dosage / Q000627:therapeutic use; D013806:Theophylline / Q000627:therapeutic use; D016896:Treatment Outcome; D014474:Unconsciousness / Q000628:therapy
D001993:Bronchodilator Agents; D013806:Theophylline; D009241:Ipratropium; D013726:Terbutaline; D000420:Albuterol