Paramedics’ perceptions of asthma patients and the use of β₂ agonists within the acute setting. (ID 447)
Kingston University, London
Funding: None
Abstract
Background: The heterogeneous nature of asthma results in a wide range of presentations during exacerbation. Despite clear pre-hospital management guidelines centred around β₂ agonists the diversity of variables present such as cause, severity, underlying health, comorbidity and drug side effects can often make emergency treatment optimisation difficult. We sought to explore and better understand how paramedics observe, perceive, interpret and treat asthma patients, often basing their actions on minimal information within a rapidly developing situation.Method: We recruited paramedics from within a single UK NHS ambulance Trust to qualitative semi-structured online interviews. All interviews were analysed using framework analysis to allow for a thematic inductive and deductive approach.
Results: Fifteen qualitative interviews were undertaken with paramedics (n= 11 experienced; n= 2 newly qualified; n= 2 practitioners). Deductive analysis identified three main themes that impact how paramedics approach their patient: Adaption; Experience and Severity of Side Effects. Paramedics perceived that their ability to manage a range of asthma presentations was due to their ability to adapt guidelines with the support of their own clinical experience and an awareness of β₂ agonist side effects, allowing them to predicate their response in-line with a series of compounding factors. Further inductive analysis identified additional complexities such as anxiety, pregnancy, and diabetes which can both alter how they use β₂ agonist and result in multiple care pathways being initiated to support the patient alongside the exacerbation.
Conclusion: The care provided by paramedics reflects the heterogeneity nature of the condition and accounts for a range of characteristics that may present. A dynamic approach allows patients to be managed based on their presenting condition(s), opposed to a singular algorithm that may be stated within guidelines. Further research is required to understand changes to patient presentations when managed using standard drug regimens and how this impacts clinical outcomes.
Conflicts of interest: None
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