BMC Emerg Med. 2025 Dec 5. doi: 10.1186/s12873-025-01437-z. Online ahead of print.

BACKGROUND: Despite breathlessness (dyspnoea) being a common and serious symptom that often necessitates ambulance care, there is still a limited understanding of how ambulance clinicians (ACs) experience and manage these situations in the pre-hospital setting. Given the potential severity and complexity of breathlessness, as well as its impact on patient outcomes, a deeper insight into ACs’ perspectives is essential. This study aimed to explore ACs experiences of caring for patients with breathlessness within ambulance services.

METHODS: An inductive qualitative design was employed. Data were collected through dyadic interviews with 16 ACs from two ambulance organizations in southwestern Sweden during two days in May and June 2021. The data were analyzed using qualitative content analysis.

RESULTS: The ACs experienced several challenges in caring for patients with breathlessness, which is captured in three generic categories: navigating patients’ experiences during breathlessness, navigating relatives and their involvement, and navigating one’s own capability in care. ACs highlighted challenges of identifying and addressing patients’ individual needs, emphasizing the crucial role of trust-building. While ACs relied on their clinical expertise, assessing a patient’s condition remained challenging in certain situations. Furthermore, their ability to manage stress and emotional demands were essential for providing quality care.

CONCLUSIONS: This study underscores the challenges of caring for patients with breathlessness, with ACs employing strategies to manage stress and establish a safe environment. Clinical experience and ongoing training and education are strategies to strengthen clinical reasoning and decision-making. Pairing less experienced ACs with seasoned colleagues could also improve care quality and support the development of professional competence.

PubMed:41350833 | DOI:10.1186/s12873-025-01437-z