Patients' perspectives on point-of-care diagnostics and treatment by emergency medical technicians in acute COPD exacerbations: A qualitative study

H M Christensen; P I Pietersen; C B Laursen; D Wittrock; G Nadim; G Jørgensen; L B Nielsen; M K Sørensen; I L Titlestad; A T Lassen; S Mikkelsen

doi:10.1186/s13049-022-00999-2

Patients' perspectives on point-of-care diagnostics and treatment by emergency medical technicians in acute COPD exacerbations: A qualitative study

Scand J Trauma Resusc Emerg Med. 2022 Feb 19;30(1):11. doi: 10.1186/s13049-022-00999-2.

Authors

H M Christensen^{1

2}, P I Pietersen³, C B Laursen^{3

4}, D Wittrock⁵, G Nadim⁶, G Jørgensen⁷, L B Nielsen⁸, M K Sørensen⁸, I L Titlestad³, A T Lassen⁶, S Mikkelsen⁹

Affiliations

¹ Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29 entrance 87-88, 5000, Odense C, Denmark. Helle.marie.christensen@rsyd.dk.
² Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Helle.marie.christensen@rsyd.dk.
³ Department of Respiratory Medicine, Odense University Hospital, Sdr. Boulevard 29 entrance 87-88, 5000, Odense C, Denmark.
⁴ Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
⁵ Ambulance Syd, Odense, Denmark.
⁶ Emergency Medicine Research Unit, Odense University Hospital, Odense, Denmark.
⁷ Department of Health Planning, Prehospital Services, Region of Southern Denmark, Vejle, Denmark.
⁸ Responce & Falck Danmark, Kolding, Denmark.
⁹ The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.

Abstract

Background: 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. 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 objectives: To 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.

Method: A 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.

Results: The 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.

Conclusion: 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. 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.

Keywords: COPD; Exacerbation; Patient perspectives; Point-of-care; Prehospital.

MeSH terms

Dyspnea
Emergency Medical Technicians*
Humans
Point-of-Care Testing
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / therapy
Qualitative Research