Patients included in the intervention group will be treated with inhaled bronchodilator nebulised with compressed atmospheric air (21% oxygen) at a flow rate of 6-8 l/min. A bi-nasal EtCO2 meter will be placed in the patient’s nose during nebulisation for EtCO2 measuring during treatment and while delivering supplemental oxygen, as needed. During nebulisation, oxygen will be titrated to achieve a SpO2 of 88-92%. The need for additional bronchodilator treatment will be assessed at the discretion of the treating EMS provider according to local standard operatin procedure. When nebulised bronchodilators are not being delivered, the patient will receive supplemental oxygen to achieve a SpO2 of 88-92%. At hospital arrival, the patient will have an arterial blood gas drawn and analysed within 30 min.
Patients included in the control group (standard treatment) will be treated with inhaled bronchodilators nebulised with oxygen (100%) at a flow rate of 6-8 l/min. A bi-nasal EtCO2meter will be placed in the patient’s nose during nebulisation for EtCO2 measurement during treatment and transport, which also masks the patient for group allocation. The need of additional bronchodilator treatment will be assessed at the discretion of the treating EMS provider, according to local standard operating procedures. When nebulised bronchodilators are not being delivered, the patient will receive supplemental oxygen according to local standard operating procedure. At hospital arrival, the patient will have an arterial blood gas drawn and analysed within 30 min.
