If this is the case, I would tend to agree. If such a patient showed up in my ED and we did the same care, that patient would be coded as "respiratory failure." It very well could be the case that the "respiratory failure" patient gets coded as some sort of "respiratory insufficiency" and not failure because the patient is no longer in frank failure upon arrival at the ED.Here's my question. EMS responds to a patient with difficulty breathing with trouble speaking between breaths. The patient has a cardiac history. S/he is hypertensive with adventitious breath sounds. Initial SpO2 in the high 70s. The patient gets a 12-lead ECG, nitroglycerin, and CPAP. By arrival in the ED the patient is doing much better. Respiratory rate is now 24 (down from 40) and SpO2 is 98. Does it get "coded" at the hospital as "respiratory failure"? If not this entire study needs to be thrown in the garbage.
You make an excellent point about a huge problem that may just lie at the heart of the study.