{
  "abstract": "Background Blood gas (BG) analysis is frequently used to detect Acute Hypercapnic Respiratory Failure (AHRF), a serious disease. National audits on AHRF primarily focus on patients referred to respiratory medicine or critical care, leaving the true incidence of AHRF in the Emergency Department (ED) largely underreported. This audit was aiming to analyse BG tests conducted in ED to determine the occurrence of AHRF in critically ill adult patients.Methods A single-center audit was conducted in December 2024, involving 500 consecutive adult patients in the Majors & Resuscitation areas of ED, 187 of whom underwent BG testing. Demographic, clinical, and BG data were reviewed to determine the incidence of AHRF based on the British Thoracic Society (BTS) and Intensive Care Society (ICS) criteria.Results Among 500 patients, 187 (37.4%) had blood gas (BG) test done, and respiratory acidosis was detected in 25 (13%) patients. 84% of all BG samples were venous, and 60% were taken within 60 minutes of ED admission. The mean age of these patients was 68.8 years, and a mean body mass index was 26.5 kg/m 2. The patients with respiratory acidosis had a greater referral rate to general medicine compared to others (68% vs. 64%, p < 0.05), treatment time was significantly shorter for these patients (91 minutes vs. 137 minutes, p<0.05). Four patients in the respiratory acidosis group needed ventilatory support; two of them were intubated and two of them got non-invasive ventilation (NIV).Conclusion AHRF was promptly identified and referred for treatment in the ED, with ventilatory support initiated in a timely manner despite department pressures. Incidentally, our hospital’s BG testing rate was considerably higher than international benchmarks, likely due to the frequent use of venous samples. Further multicentre surveys are needed to better understand the true incidence of AHRF in ED.",
  "authors": [
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "MJ Akram"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "J Jain"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "B Rashid"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "AO Ugurlu"
    },
    {
      "affiliations": [
        "Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "R Mukherjee"
    }
  ],
  "title": "P236 Acute hypercapnic respiratory failure: assessing the incidence in the emergency department",
  "uid": "fe0f3755-580c-5386-8541-bd88ae756a27"
}