PT  - JOURNAL ARTICLE
AU  - Anna Moore
AU  - John Martin
AU  - John Bowen
AU  - Paul Katterhorn
AU  - Anthony Davison
TI  - 17% of patients who call an ambulance for an exacerbation of COPD could be treated at home
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p4624
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p4624.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p4624.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: COPD is a chronic condition and healthcare policy in almost all countries is to try and deliver as much care for chronic diseases in the community and reduce the reliance and expense of hospital care. The National Clinical Guideline Centre (NICE) guidelines for COPD (2010) (www.nice.org.uk/guidance/CG101) give clear recommendation for factors to consider when deciding to treat a patient at home. The aim of this study was to see what percentages of patients who had an exacerbation of COPD and call an ambulance meet the criteria for home treatment.Methods: All 18 patients who had called an ambulance because of an exacerbation of COPD in 17 days were included in the study. The ambulance service recorded the 12 relevant factors from the NICE guideline which should be considered when deciding to treat a patient at home on a proforma over 17 days.Results: Saturation was ≤ 87% in 9 patients. 6 were not able to cope at home, 8 had severe breathlessness, 7 had poor general condition, 10 had poor level of activity, none were cyanosed, 4 had worsening peripheral oedema, all had a normal level of consciousness, 6 were receiving LTOT, 7 were living alone or not coping, no patients recorded having acute confusion, 6 had a rapid rate of onset, 5 had significant comorbidities.Conclusions: 3 of the 18 patients (17%) had no factor that indicated that there was a need to be treated in hospital. The majority of patients who call an ambulance with an exacerbation get taken to hospital. Hospital at home for COPD has been proven to be successful and 17% of patients who call an ambulance could be safely managed in such a scheme. This would avoid them being assessed and admitted to hospital.