• Asthma: an overview of prehospital care

      Scholes, Steven (2008-12)
      Asthma exacerbations are characterized by progressive increase in shortness of breath, decrease in expiratory airflow, productive or non-productive cough, wheezing and feeling of chest tightness. Emergency hospital admissions for asthma are costly and it is estimated 75% are avoidable through effective asthma management and routine care. This article addresses asthma management in prehospital care explaining relevant underlying pathophysiology of asthma exacerbations to provide clinicians with a greater understanding of asthma and its pharmacological and ventilatory management. Abstract published with permission.
    • COPD: an overview of prehospital care

      Scholes, Steven; Hedges, Nicola (2009-12-18)
      Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. It is a debilitating airways disease which presents to the ambulance service with varying severity and is characterized by airflow obstruction which is usually progressive, not fully reversible and does not change markedly over several months. It may coexist with other comorbidities such as cardiovascular disease, making diagnosis of exacerbations difficult. COPD management in the prehospital environment is focused on effective recognition and the early application of pharmacological intervention to alleviate symptoms using current Joint Royal Colleges Ambulance Liaison Committee Guidelines. Abstract published with permission.
    • Heliox in acute severe asthma in the A&E setting: a review

      Scholes, Steven (2013-09-29)
      Heliox (HeO2) is a mixture of helium and oxygen, often mixed in 80:20 or 70:30 ratios for use in medicine and clinical investigations. Heliox has been available for use in the UK since 2002 and is supplied as Heliox 21 (21% oxygen and 79% helium) by BOC Gases for medical use in asthma, croup, chronic obstructive pulmonary disease and other medical procedures. Heliox use in asthma exacerbations remains largely experimental owing to the limited number of randomized controlled trials. This review aims to critically analyse the efficiency of Heliox use in acute asthma exacerbations in the Accident and Emergency (A&E) setting, evaluate its effectiveness as a medium for nebulization, and assess potential benefits to clinical practice. Prehospital application will also be discussed in moderate-severe asthma exacerbations. It is envisaged that the factors relating to Heliox use in asthma are focused to provide an additional therapy to the current choice of therapies for prehospital clinicians. Abstract published with permission.