Acute respiratory insufficiency due to obstructive pulmonary diseases is a common problem presenting to the emergency medical service. Most frequent causes are acute asthma attacks or acute exacerbations of chronic obstructive pulmonary disease (COPD). The preclinical differentiation of both diseases may be difficult, so that the diagnosis is often made by precise anamnesis. This article reviews the prehospital management of asthma and COPD, including pharmacological options and techniques of mechanical ventilatory support (non-invasive vs. invasive).
Zusammenfassung
Die akute respiratorische Insuffizienz auf dem Boden obstruktiver Ventilationsst?rungen ist ein h?ufig vorkommendes Krankheitsbild im Rettungsdienst. In den meisten F?llen sind dabei der akute Asthmaanfall und die akut exazerbierte chronisch obstruktive Lungenerkrankung (chronic obstructive pulmonary disease ? COPD) urs?chlich. Eine genaue Differenzierung von Asthma bronchiale und COPD kann pr?klinisch bei eingeschr?nkten diagnostischen M?glichkeiten schwierig sein, sodass die Verdachtsdiagnose h?ufig auf Eigen- oder Fremdanamnese basiert. Es soll insbesondere auf die pr?klinischen Basisma?nahmen, die pharmakologischen Therapieoptionen und auf die apparativen Verfahren einer Atmungsunterst?tzung (nicht invasiv vs. invasiv) eingegangen werden.
The prevalence of obesity has increased steadily in recent years. Obese people often suffer from diseases which acute decompensation requires a prompt prehospital therapy. The Emergency Medical Service will be confronted with difficulties in clinical diagnostic, therapy and especially with a delayed management of rescue and transport. It is most important to avoid prehospital depreciation in quality and time management. This article reviews the specific requirements of prehospital care of obese persons and discusses possible solutions to optimize the prehospital therapy.
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