A breath of fresh air: a case report on respiratory failure in UK ambulance service

Chronic obstructive pulmonary disease (COPD) is one of the biggest killers in the world. Patients in intensive care unit (ICU) with elongated episodes of respiratory failure have poor outcomes. Exacerbations (from minor exacerbations to respiratory failure) are a common presentation to the ambulance service. This article presents the case of a patient in their early 60s was suffering respiratory failure because of an exacerbation of COPD. They tried their inhaler to no effect. They managed their respiratory failure using their home continuous positive airway pressure while awake for the first time to help them have adequate ventilation. JRCALC advises that assisted ventilation should be performed while transporting a patient with respiratory failure to the hospital. However, performing assisted ventilations in a moving vehicle is challenging and potentially ineffective. Allowing emergency ambulance staff to access non-invasive ventilations to manage these patients could improve patient care and prevent ICU stays but more research is needed.