Background: Acute heart failure and chronic obstructive pulmonary disease (COPD) exacerbation are common, and are sometimes difficult to differentiate in the emergency department (ED). Objectives: To determine the clinical impact of Point-of-Care Ultrasonography (POCUS) in ED patients with suspected acute heart failure or COPD. Methods: We conducted a prospective health records review with 1:3 matching, and analyzed time to events using time-dependent Cox regression analyses, classification performance, and adverse events. Results: There were 81 patients with lung POCUS and 243 matched patients. No differences were found in ED length of stay or length of care, nor adverse events. Significance was found for time to treatment (P=0.03). Lung POCUS had high sensitivity (92.5%) and specificity (85.7%) for identifying acute heart failure. Conclusions: Lung POCUS could result in faster treatments for patients with suspected acute heart failure and COPD, and has high accuracy in identifying acute heart failure.

Bakgrund: I Sverige söker årligen 85 000 personer akutmottagningen på grund av andningsbesvär/andnöd. Då denna andnöd potentiellt kan orsaka stort lidande för de drabbade, är det viktigt att dessa patienter tas om hand på bästa möjliga sätt. Då den vård som erbjuds idag bör vara inriktad mot varje patients individuella behov, är det av stor vikt att undersöka vilka upplevelser patienter som söker för akut andnöd faktiskt beskriver. Syfte: Syftet var att beskriva patienters upplevelser i samband med akut andnöd, utifrån Katie Erikssons omvårdnadsteori om den lidande människan. Metod: Databaserna CINAHL och PubMed användes för att söka fram lämpliga artiklar till denna litteraturöversikt. Efter litteraturgranskning kom 16 artiklar att inkluderas. Innehållet i artiklarna analyserades utifrån syftet och sattes samman under lämpliga rubriker med en teoretisk referensram som utgångspunkt. Resultat: Tre huvudkategorier som svarade till syftet skapades. ”Patienters upplevelser av sjukdomslidande” visade hur patienterna upplevde både ett fysiskt och ett psykiskt lidande, utifrån andnöden i sig men också på grund av en påfrestande behandling. ”Patienters upplevelser av vårdlidandet” lyfte bland annat bemötandet från vårdpersonalen som betydelsefullt och vikten av information och delaktighet. ”Patienters upplevelser av livslidande” beskriver slutligen bland annat patienters tankar kring framtiden och anhörigas betydelse. Slutsats: Att uppleva en akut andnöd innebär ett stort lidande för många patienter, både ur fysiska och psykiska aspekter. För att lidandet ska kunna lindras krävs det att vårdpersonalen är närvarande, lyssnar, informerar och sätter patientens individuella behov i fokus. Det krävs även att patienten tillåts vara delaktig i processen. Genom att vårdpersonalen arbetar för att inkludera patienten kan vården bättre anpassas efter patientens behov och på så vis förbättra patientens upplevelser och minska lidandet. / Background: In Sweden, 85 000 people visit the emergency department yearly due to shortness of breath. As this shortness of breath can potentially cause great suffering, it’s important that these patients are cared for in the best possible way. As the care offered should focus on each patient's needs and experiences, it’s of great importance to examine what experiences patients with an acute shortness of breath actually describe. Aim: The aim was to describe patients’ experiences when suffering from acute shortness of breath, based on Katie Eriksson’s nursing theory about the suffering person. Methods: This literature review used the databases CINAHL and PubMed to search for suitable articles. A total of 16 articles were included. The content of the articles was analyzed and put together under suitable headings with a theoretical framework as a starting point. Results: Three main categories were created. “Patients' experiences of disease suffering” showed how the patients experienced both physical and psychological suffering, based on the shortness of breath itself and also due to a stressful treatment. “Patients' experiences of the care suffering” highlighted the personal approach from the healthcare staff as significant, as well as the importance of information and participation. “Patients' experiences of life suffering” describes patients' thoughts about the future and the importance of relatives. Conclusion: Experiencing acute shortness of breath means great suffering for many patients, both physically and psychologically. In order for the suffering to be alleviated it is necessary for the healthcare staff to be present, listen, inform and put the patient’s individual needs first. The patient also needs to be allowed to participate in the process. If the healthcare staff strives to include the patient, the care can be adapted to the patient’s needs and thus improve the patient’s experiences and reduce suffering.

Значительная доля людей, столкнувшихся с коронавирусной инфекцией имеют осложнение в виде COVID-19-ассоциированной пневмонии и нуждаются в доступной и квалифицированной реабилитации. Цель работы - оценить влияние программы физической реабилитации на толерантность к физическим нагрузкам и функциональное состояние кардио-респираторной системы пациентов, перенесших COVID-19-ассоциированную пневмонию. В исследовании приняли 20 пациентов, перенесших COVID-19-ассоциированную пневмонию. В работе использовались следующие методы исследования: оценка толерантности к физической нагрузке оценивалась с помощью теста шестиминутной ходьбы, для оценки степени одышки после нагрузки использовалась шкала Борга, определяли сатурацию в покое и после проведения теста шестиминутной ходьбы, оценивалась частота сердечных сокращений до и после тестирования, а также выраженность одышки при повседневной деятельности оценивалась по шкале mMRC. Согласно полученным результатам, разработанная программа реабилитации повлияла на повышение толерантности к физическим нагрузкам, улучшение функционального состояния кардио-респираторной системы и субъективной переносимости физической нагрузки у пациентов, перенесших COVID-19-ассоциированную пневмонию. / A significant proportion of people who have experienced coronavirus infection have a complication in the form of COVID-19-associated pneumonia and need affordable and qualified rehabilitation. The aim of the work was to evaluate the impact of the physical rehabilitation program on exercise tolerance and the functional state of the cardio-respiratory system in patients who had undergone COVID-19-associated pneumonia. The study included 20 patients with COVID-19-associated pneumonia. Research methods were used in the work: assessment of exercise tolerance was assessed using a six-minute walk test, the Borg scale was used to assess the degree of dyspnea after exercise, saturation was determined at rest and after a six-minute walk test, heart rate was assessed before and after testing, as well as the severity of dyspnea during daily activities was assessed using the mMRC scale. According to the results obtained, the developed rehabilitation program influenced the increase in exercise tolerance, the improvement of the functional state of the cardio-respiratory system and the subjective exercise tolerance in patients who underwent COVID-19-associated pneumonia.