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Prehospital improvisation of standard oxygen therapy equipment to facilitate delivery of a bronchodilator in a supine patient
  1. David Fitzpatrick1,
  2. James A Brady2,
  3. Donogh Maguire3
  1. 1Clinical Research Paramedic, Scottish Ambulance Service, NMAHP Research Unit, University of Stirling, UK
  2. 2Clinical Supervisor, Scottish Ambulance Service, West of Scotland Emergency Medical Despatch Centre, Cardonald, Glasgow, UK
  3. 3Emergency Medicine Consultant, Monklands District General Hospital, Airdrie, Lanarkshire, UK
  1. Correspondence to David Fitzpatrick, Clinical Research Paramedic, Scottish Ambulance Service, NMAHP Research Unit, Iris Murdoch Building, University of Stirling, Stirling FK9 4LA, UK; david.fitzpatrick{at}

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A police request was made to the ambulance service to attend an adult victim of an alleged assault. On arrival the patient was found to be alert (AVPU: alert, responds to verbal stimuli, responds to pain, unresponsive), in a seated position, and complaining of head, neck and back pain. The airway was clear; a mild diffuse polyphonic wheeze was noted bilaterally throughout both lungs. Respiratory rate was 16 bpm and heart rate was 126 bpm. Oxygen therapy was commenced via a duo mask (fractional inspired oxygen (FiO2) 0.53) as oxygen saturation was recorded initially at 94% on air. The mechanism of injury caused concern regarding possible c-spine injury as the patient's head had been struck forcefully against the wall. The patient denied any loss of consciousness. Bony tenderness was elicited during c-spine examination and a c-spine collar was applied with full spinal precautions. The patient was immobilised using …

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  • Competing interests None.

  • Patient consent Despite Caldecott approval being granted, it was not possible to locate the patient and gain consent and so in place of this the authors have anonymised the content.

  • Provenance and peer review Not commissioned; externally peer reviewed.