{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T17:15:10Z","timestamp":1756574110391,"version":"3.37.3"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Scand J Trauma Resusc Emerg Med"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Acute dyspnoea is common among ambulance patients, but little is known of the patients\u2019 experience of symptom. We aimed to investigate ambulance patients initial perceived intensity of acute dyspnoea, and whether they experienced relief during prehospital treatment. Furthermore, to investigate the validity and feasibility of using a subjective dyspnoea score in the ambulance, and its association with objectively measured vital signs.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a prospective observational study in the North Denmark Region from 1. July 2017 to 30. March 2019. We studied patients over the age of 18 to whom an ambulance was dispatched. Patients with acute dyspnoea assessed either at the emergency call or by ambulance professionals on scene were included. Patients were asked to assess dyspnoea on a 0 to 10 verbal numeric rating scale at the primary contact with the ambulance personnel and immediately before release at the scene or arrival at the hospital. Patients received usual prehospital medical treatment. We used visual inspection and Wilcoxon matched-pairs signed-ranks test, to assess dyspnoea scores and change hereof. Scatterplots and linear regression analyses were used to assess associations between the dyspnoea score and vital signs.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>We included 3199 patients with at least one dyspnoea score. Of these, 2219 (69%) had two registered dyspnoea scores. The initial median dyspnoea score for all patients was median 8 (interquartile range 6\u201310). In 1676 (76%) of patients with two scores, the first score decreased from 8 (6\u20139) to 4 (2\u20135) during prehospital treatment. The score was unchanged for 370 (17%) and increased for 51 (2%) patients. Higher respiratory rate, blood pressure, and heart rate was seen with higher dyspnoea scores whereas blood oxygen saturation lowered.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We found that acute dyspnoea scored by ambulance patients, was high on a verbal numerical rating scale but decreased before arrival at hospital, suggesting relief of symptoms. The acute dyspnoea score was statistically associated with vital signs, but of limited clinical relevance; this stresses the importance of patients\u2019 experience of symptoms. To this end, the dyspnoea scale appears feasible in the prehospital setting.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13049-020-0715-2","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T11:18:31Z","timestamp":1585912711000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patient experience of severe acute dyspnoea and relief during treatment in ambulances: a prospective observational study"],"prefix":"10.1186","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-7859","authenticated-orcid":false,"given":"Tim Alex","family":"Lindskou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1975-3654","authenticated-orcid":false,"given":"Ulla M\u00f8ller","family":"Weinreich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"L\u00fcbcke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torben Anders","family":"Kl\u00f8jgaard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4300-4645","authenticated-orcid":false,"given":"Birgitte Schantz","family":"Laursen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-7027","authenticated-orcid":false,"given":"S\u00f8ren","family":"Mikkelsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-9694","authenticated-orcid":false,"given":"Erika Frischknecht","family":"Christensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"issue":"4","key":"715_CR1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1164\/rccm.201111-2042ST","volume":"185","author":"MB Parshall","year":"2012","unstructured":"Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435\u201352. https:\/\/doi.org\/10.1164\/rccm.201111-2042ST.","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"715_CR2","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/SPC.0b013e328300cad0","volume":"2","author":"AP Abernethy","year":"2008","unstructured":"Abernethy AP, Wheeler JL. Total dyspnoea. Curr Opin Support Palliat Care. 2008;2(2):110\u20133. https:\/\/doi.org\/10.1097\/SPC.0b013e328300cad0.","journal-title":"Curr Opin Support Palliat Care"},{"issue":"4","key":"715_CR3","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/MEJ.0b013e3280b17ebb","volume":"14","author":"OS Gunnarsdottir","year":"2007","unstructured":"Gunnarsdottir OS, Rafnsson V. Seven-year evolution of discharge diagnoses of emergency department users. Eur J Emerg Med. 2007;14(4):193\u20138. https:\/\/doi.org\/10.1097\/MEJ.0b013e3280b17ebb.","journal-title":"Eur J Emerg Med"},{"issue":"1","key":"715_CR4","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1186\/s12913-018-3361-x","volume":"18","author":"MB S\u00f8vs\u00f8","year":"2018","unstructured":"S\u00f8vs\u00f8 MB, Hermansen SB, F\u00e6rk E, et al. Diagnosis and mortality of emergency department patients in the North Denmark region. BMC Health Serv Res. 2018;18(1):548. https:\/\/doi.org\/10.1186\/s12913-018-3361-x.","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"715_CR5","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1111\/acem.12380","volume":"21","author":"ME Prekker","year":"2014","unstructured":"Prekker ME, Feemster LC, Hough CL, et al. The epidemiology and outcome of Prehospital respiratory distress. Mark Courtney D, ed. Acad Emerg Med. 2014;21(5):543\u201350. https:\/\/doi.org\/10.1111\/acem.12380.","journal-title":"Acad Emerg Med"},{"key":"715_CR6","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/1472-6963-14-380","volume":"14","author":"V Pittet","year":"2014","unstructured":"Pittet V, Burnand B, Yersin B, Carron P-N. Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis. BMC Health Serv Res. 2014;14:380. https:\/\/doi.org\/10.1186\/1472-6963-14-380.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"715_CR7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/1757-7241-21-53","volume":"21","author":"MS Andersen","year":"2013","unstructured":"Andersen MS, Johnsen SP, S\u00f8rensen JN, Jepsen SB, Hansen JB, Christensen EF. Implementing a nationwide criteria-based emergency medical dispatch system: a register-based follow-up study. Scand J Trauma Resusc Emerg Med. 2013;21(1):53. https:\/\/doi.org\/10.1186\/1757-7241-21-53.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"3","key":"715_CR8","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/MEJ.0b013e3280146508","volume":"14","author":"L Hj\u00f6lte","year":"2007","unstructured":"Hj\u00f6lte L, Suserud B-O, Herlitz J, Karlberg I. Why are people without medical needs transported by ambulance? A study of indications for pre-hospital care. Eur J Emerg Med. 2007;14(3):151\u20136. https:\/\/doi.org\/10.1097\/MEJ.0b013e3280146508.","journal-title":"Eur J Emerg Med"},{"issue":"2","key":"715_CR9","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/SPC.0b013e3282ffafe8","volume":"2","author":"C Bausewein","year":"2008","unstructured":"Bausewein C, Booth S, Higginson IJ. Measurement of dyspnoea in the clinical rather than the research setting. Curr Opin Support Palliat Care. 2008;2(2):95\u20139. https:\/\/doi.org\/10.1097\/SPC.0b013e3282ffafe8.","journal-title":"Curr Opin Support Palliat Care"},{"issue":"5","key":"715_CR10","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.rmed.2012.12.018","volume":"107","author":"G Scano","year":"2013","unstructured":"Scano G, Gigliotti F, Stendardi L, Gagliardi E. Dyspnea and emotional states in health and disease. Respir Med. 2013;107(5):649\u201355. https:\/\/doi.org\/10.1016\/j.rmed.2012.12.018.","journal-title":"Respir Med"},{"key":"715_CR11","doi-asserted-by":"publisher","unstructured":"Spector N, Connolly MA, Carlson KK. Dyspnea: applying research to bedside practice. AACN Adv Crit Care. 2007;18(1):45\u201358 quiz 59\u201360. https:\/\/doi.org\/10.4037\/15597768-2007-1006.","DOI":"10.4037\/15597768-2007-1006"},{"issue":"6","key":"715_CR12","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1111\/j.1742-6723.2008.01132.x","volume":"20","author":"A Saracino","year":"2008","unstructured":"Saracino A, Weiland T, Dent A, Jolly B. Validation of a verbal dyspnoea rating scale in the emergency department. Emerg Med Australas. 2008;20(6):475\u201381. https:\/\/doi.org\/10.1111\/j.1742-6723.2008.01132.x.","journal-title":"Emerg Med Australas"},{"issue":"3","key":"715_CR13","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1067\/men.2000.107012","volume":"26","author":"KR Kendrick","year":"2000","unstructured":"Kendrick KR, Baxi SC, Smith RM. Usefulness of the modified 0-10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. J Emerg Nurs. 2000;26(3):216\u201322. https:\/\/doi.org\/10.1067\/men.2000.107012.","journal-title":"J Emerg Nurs"},{"issue":"12","key":"715_CR14","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1164\/rccm.201503-0419OC","volume":"192","author":"HS Haugdahl","year":"2015","unstructured":"Haugdahl HS, Storli SL, Meland B, Dybwik K, Romild U, Klepstad P. Underestimation of patient breathlessness by nurses and physicians during a spontaneous breathing trial. Am J Respir Crit Care Med. 2015;192(12):1440\u20138. https:\/\/doi.org\/10.1164\/rccm.201503-0419OC.","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"715_CR15","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1002\/jhm.2600","volume":"11","author":"MS Stefan","year":"2016","unstructured":"Stefan MS, Priya A, Martin B, et al. How well do patients and providers agree on the severity of dyspnea? J Hosp Med. 2016;11(10):701\u20137. https:\/\/doi.org\/10.1002\/jhm.2600.","journal-title":"J Hosp Med"},{"issue":"3","key":"715_CR16","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1177\/0269216307076398","volume":"21","author":"S Dorman","year":"2007","unstructured":"Dorman S, Byrne A, Edwards A. Which measurement scales should we use to measure breathlessness in palliative care? A systematic review. Palliat Med. 2007;21(3):177\u201391. https:\/\/doi.org\/10.1177\/0269216307076398.","journal-title":"Palliat Med"},{"issue":"3","key":"715_CR17","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.rmed.2006.07.003","volume":"101","author":"C Bausewein","year":"2007","unstructured":"Bausewein C, Farquhar M, Booth S, Gysels M, Higginson IJ. Measurement of breathlessness in advanced disease: a systematic review. Respir Med. 2007;101(3):399\u2013410. https:\/\/doi.org\/10.1016\/j.rmed.2006.07.003.","journal-title":"Respir Med"},{"issue":"12","key":"715_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/17476348.2017.1387052","volume":"11","author":"AJ Justicia-Grande","year":"2017","unstructured":"Justicia-Grande AJ, Pardo Seco J, Rivero Calle I, Martin\u00f3n-Torres F. Clinical respiratory scales: which one should we use? Expert Rev Respir Med. 2017;11(12):1\u201319. https:\/\/doi.org\/10.1080\/17476348.2017.1387052.","journal-title":"Expert Rev Respir Med"},{"issue":"5","key":"715_CR19","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1742-6723.2007.00999.x","volume":"19","author":"A Saracino","year":"2007","unstructured":"Saracino A. Review of dyspnoea quantification in the emergency department: is a rating scale for breathlessness suitable for use as an admission prediction tool? Emerg Med Australas. 2007;19(5):394\u2013404. https:\/\/doi.org\/10.1111\/j.1742-6723.2007.00999.x.","journal-title":"Emerg Med Australas"},{"issue":"5","key":"715_CR20","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1136\/emj.2007.048611","volume":"27","author":"H Mohan","year":"2010","unstructured":"Mohan H, Ryan J, Whelan B, Wakai A. The end of the line? The visual analogue scale and verbal numerical rating scale as pain assessment tools in the emergency department. Emerg Med J. 2010;27(5):372\u20135. https:\/\/doi.org\/10.1136\/emj.2007.048611.","journal-title":"Emerg Med J"},{"issue":"2","key":"715_CR21","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.accpm.2014.09.001","volume":"34","author":"R Placido","year":"2015","unstructured":"Placido R, Gigaud C, Gayat E, et al. Assessment of dyspnoea in the emergency department by numeric and visual scales: a pilot study. Anaesth Crit Care Pain Med. 2015;34(2):95\u20139. https:\/\/doi.org\/10.1016\/j.accpm.2014.09.001.","journal-title":"Anaesth Crit Care Pain Med"},{"issue":"2\u20133","key":"715_CR22","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.resp.2007.01.006","volume":"157","author":"NR Morris","year":"2007","unstructured":"Morris NR, Sabapathy S, Adams L, Kingsley RA, Schneider DA, Stulbarg MS. Verbal numerical scales are as reliable and sensitive as visual analog scales for rating dyspnea in young and older subjects. Respir Physiol Neurobiol. 2007;157(2\u20133):360\u20135. https:\/\/doi.org\/10.1016\/j.resp.2007.01.006.","journal-title":"Respir Physiol Neurobiol"},{"key":"715_CR23","unstructured":"Statistics Denmark. FOLK1A: Folketal den 1. i kvartalet efter omr\u00e5de, k\u00f8n, alder og civilstand [FOLK1A: Population the 1. of the quarter, by area, sex, age and marital status]. https:\/\/www.statistikbanken.dk\/FOLK1A. Published 2019. Accessed 9 Oct 2019."},{"key":"715_CR24","unstructured":"Statistics Denmark. ARE207: Areal 1. januar efter omr\u00e5de [ARE207: Area 1. January according to region]. https:\/\/www.statistikbanken.dk\/are207. Published 2019. Accessed 22 Oct 2019."},{"key":"715_CR25","unstructured":"Danish Regions. Dansk Indeks for Akuthj\u00e6lp [Danish Index for Emergency Care]. https:\/\/pri.rn.dk\/Assets\/30522\/Dansk-Indeks-1-8-Region-Nordjylland.pdf. Published 2017. Accessed 11 Nov 2019."},{"key":"715_CR26","unstructured":"Physio-Control. LIFEPAK 15 MONITOR\/DEFIBRILLATOR. Operating Instructions. https:\/\/www.physio-control.com\/uploadedFiles\/Physio85\/Contents\/Workplace_and_Community\/Products\/3301020_H_LR.pdf. Published 2015. Accessed October 7, 2019."},{"issue":"10","key":"715_CR27","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1371\/journal.pmed.0040296","volume":"4","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. https:\/\/doi.org\/10.1371\/journal.pmed.0040296.","journal-title":"PLoS Med"},{"issue":"4","key":"715_CR28","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.hlc.2007.11.137","volume":"17","author":"A Saracino","year":"2008","unstructured":"Saracino A, Weiland T, Dent A, Jolly B. Validation of a verbal rating scale for breathlessness amongst patients referred for cardiac stress tests. Heart Lung Circ. 2008;17(4):305\u201312. https:\/\/doi.org\/10.1016\/j.hlc.2007.11.137.","journal-title":"Heart Lung Circ"},{"key":"715_CR29","unstructured":"Emergency Medical Services North Denmark Region. Pr\u00e6hospital \u2013 Vurdering og behandling af patienter [Prehospital - Evaluation and treatment of patients]. https:\/\/pri.rn.dk\/Sider\/13206.aspx. Published 2019. Accessed 4 Nov 2019."},{"key":"715_CR30","unstructured":"World Health Organization. International Statistical Classification of Diseases and Related Health Problems 10th Revision. http:\/\/apps.who.int\/classifications\/icd10\/browse\/2016\/en. Published 2019. Accessed April 11, 2019."},{"issue":"Suppl 1","key":"715_CR31","doi-asserted-by":"publisher","first-page":"A19","DOI":"10.1136\/bmjopen-2018-EMS.52","volume":"8","author":"NR Poulsen","year":"2018","unstructured":"Poulsen NR, Kl\u00f8jg\u00e5rd TA, Holdgaard H, F\u00e6rk E, Larsen TM, Christensen E. 52 registration of prehospital vital parameters. BMJ Open. 2018;8(Suppl 1):A19\u201320. https:\/\/doi.org\/10.1136\/bmjopen-2018-EMS.52.","journal-title":"BMJ Open"},{"issue":"3","key":"715_CR32","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1586\/17476348.2016.1146595","volume":"10","author":"M Ekstr\u00f6m","year":"2016","unstructured":"Ekstr\u00f6m M, Sundh J, Larsson K. Patient reported outcome measures in chronic obstructive pulmonary disease: which to use? Expert Rev Respir Med. 2016;10(3):351\u201362. https:\/\/doi.org\/10.1586\/17476348.2016.1146595.","journal-title":"Expert Rev Respir Med"},{"issue":"2","key":"715_CR33","doi-asserted-by":"publisher","first-page":"e0213145","DOI":"10.1371\/journal.pone.0213145","volume":"14","author":"TA Lindskou","year":"2019","unstructured":"Lindskou TA, Pilgaard L, S\u00f8vs\u00f8 MB, et al. Symptom, diagnosis and mortality among respiratory emergency medical service patients. PLoS One. 2019;14(2):e0213145. https:\/\/doi.org\/10.1371\/journal.pone.0213145.","journal-title":"PLoS One"}],"container-title":["Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13049-020-0715-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13049-020-0715-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13049-020-0715-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T23:34:04Z","timestamp":1617406444000},"score":1,"resource":{"primary":{"URL":"https:\/\/sjtrem.biomedcentral.com\/articles\/10.1186\/s13049-020-0715-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,3]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["715"],"URL":"https:\/\/doi.org\/10.1186\/s13049-020-0715-2","relation":{},"ISSN":["1757-7241"],"issn-type":[{"type":"electronic","value":"1757-7241"}],"subject":[],"published":{"date-parts":[[2020,4,3]]},"assertion":[{"value":"4 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study was approved by the Danish Data Protection Agency (North Denmark region record number 2008-58-0028 and project ID number 2017\u2013128). Likewise, The Danish Patient Safety Authority approved access to prehospital patient medical records (3\u20133013-2270\/1). Finally, the North Denmark Region Committee on Health Research Ethics gave their consent for the project to be initiated without additional feedback.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"24"}}