[Prehospital treatment of patients with acute exacerbation of chronic pulmonary disease. Before and after introduction of a mobile emergency unit].
BACKGROUND
A Mobile Emergency Care Unit (MECU), manned by an anaesthesiologist and a member of the ambulance crew, was introduced in the city of Arhus in 1997. Endotracheal intubation is not performed by ambulance personnel in Denmark. The aim of this study was to describe the influence of prehospital treatment given by the MECU on the rate of endotracheal intubation, hospitalisation, and survival rate in patients suffering from acute exacerbation of chronic pulmonary disease.


METHODS
We examined the data registered for patients with chronic pulmonary disease, who called for an emergency ambulance. The study covered two periods of three months: before the introduction of the MECU (September to November 1996) and after (September to November 1997).


RESULTS
The study comprised 139 patients (72 patients before, 67 patients after). The MECU attended 57% of the patients. Endotracheal intubation was performed in eight patients: two before and six patients after, four of whom were intubated on the spot. Owing to the treatment given by the MECU on the spot, fewer patients were hospitalised, i.e. 50 patients (75%) versus 67 patients (93%) (p < 0.01). The survival rates were 76% before and 85% after.


CONCLUSIONS
The MECU was a useful supplement to the ambulance service. The MECU intubated patients with acute exacerbation of pulmonary disease in the case of life-threatening respiratory failure, and in less severe cases treated the patients at home. Thus, prehospital treatment by a physician meant fewer admissions to hospital.
Bjerre
Sanne Katrine
SK
Arhus Universitetshospital, Arhus Kommunehospital, anaestesiologisk afdeling. sannebjerre@dadlnet.dk
Hansen
Troels Martin
TM
Melchiorsen
Hanne
H
Christensen
Erika Frischknecht
EF
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000552:Ambulances / Q000706:statistics & numerical data*; D002648:Child; D003718:Denmark / Q000453:epidemiology; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data*; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012121:Respiration, Artificial; D015996:Survival Rate; D000078329:Workforce