Prehospital management of acute respiratory distress in suspected COVID-19 patients.

Autor: Jouffroy R; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France. Electronic address: romain.jouffroy@pompiersparis.fr., Lemoine S; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Derkenne C; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Kedzierewicz R; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Scannavino M; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Bertho K; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Frattini B; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Lemoine F; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Jost D; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France., Prunet B; Emergency Medicine dpt, Paris Fire Brigade, 1 place Jules Renard, 75017 Paris, France.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2021 Jul; Vol. 45, pp. 410-414. Date of Electronic Publication: 2020 Sep 14.
DOI: 10.1016/j.ajem.2020.09.022
Abstrakt: Background: In December 2019, coronavirus disease (COVID-19) emerged in China and became a world-wide pandemic in March 2020. Emergency services and intensive care units (ICUs) were faced with a novel disease with unknown clinical characteristics and presentations. Acute respiratory distress (ARD) was often the chief complaint for an EMS call. This retrospective study evaluated prehospital ARD management and identified factors associated with the need of prehospital mechanical ventilation (PMV) for suspected COVID-19 patients.
Methods: We included 256 consecutive patients with suspected COVID-19-related ARD that received prehospital care from a Paris Fire Brigade BLS or ALS team, from March 08 to April 18, 2020. We performed multivariate regression to identify factors predisposing to PMV.
Results: Of 256 patients (mean age 60 ± 18 years; 82 (32%) males), 77 (30%) had previous hypertension, 31 (12%) were obese, and 49 (19%) had diabetes mellitus. Nineteen patients (7%) required PMV. Logistic regression observed that a low initial pulse oximetry was associated with prehospital PMV (ORa = 0.86, 95%CI: 0.73-0.92; p = 0.004).
Conclusions: This study showed that pulse oximetry might be a valuable marker for rapidly determining suspected COVID-19-patients requiring prehospital mechanical ventilation. Nevertheless, the impact of prehospital mechanical ventilation on COVID-19 patients outcome require further investigations.
Competing Interests: Declaration of competing interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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