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Something to tickle your brain.


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Alright, let me pick your brains for a bit. My partner and I were called for a non emergency medical transport from a nursing home to a local hospital.

Dispatched gave us the following information "general illness" So we get to the scene and the PT is laying supine on the bed with o2 via nasal cannula. The "general illness"

problem was actually difficulty breathing follow by SOB. Find with me, I've gotten used to dispatch giving us the wrong info. It's all good. Other than the SOB PT looked fined to me.

PT was able to walk to the stretcher on his own will. So the nurse gave me report. CHF, diabetes, COPD, etc... So I ask the nurse if the PT has asthma. Nurse says, " Yeah PT has COPD,

It's the same thing" I felt like I got slapped in the head with a baseball bat, that's how shocked I was. I just stared at my partner. Now, I just want you guys profession input into this.

I know for a fact that COPD and asthma are not the same thing, although both problem affect the lungs they are completely different. I just thought this would be something good to share with the city.

Have fun.

Denny.

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It is good to see you posting again Denny.

I don't think that any nurse could make it through school without knowing the difference between asthma and COPD. I am guessing she might not have been a nurse or might have been messing with you.

Did she seem like she was serious? Was her ID badge visible?

So what were his signs ans symptoms? Vitals? Lung Sounds? Pedal edema? Bilateral or unilateral?

EDIT: Lets make a scenario out of this Bro!

Edited by DFIB
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Vitals

BP: 130/70 R: 20 P: 76 l/s wheezing bilateral. Hmm negative on the pedal edema. Coughing, shortness of breath. Dry, warm skin. A bit of a rash but nothing to big. This was a home for the veterans. So he felt strong enough to walk to the stretcher. As far as the badge thing. I did not get a glimpse at it. I mean she could have been an LPN or an aid. I do know that she was the one that gave me the paper work and report on the PT

I was in shock when that came out of her mouth, She looked serious. I did not even hear a laugh or a chuckle when she said that. Hell even the PT looked at me.

EDIT

As soon as we got him moving we switched him to a NRB 15 LPM.

Edited by EMTB.Denny389
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There are some real doosies out there!

What did the rash look like? So you were transporting for SOB? Taking him for an nebulization?

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I can't recall what the rash looked like. Yeah. The company I work is a commercial EMS company. We transfer for the littlest thing ever.... Some are good serious calls while other are things like this or headaches... abdomen pain... injured finger....

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All transports pay the same only some require less effort. I bet the chick was an LPN or simply did not care that much about the transport.

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Actually, there exists a good argument for defining asthma as a form of COPD. COPD is a catch all phrase used to describe a constellation of chronic conditions that cause obstructive pathology. In respiratory school you would be taught COPD "traditionally" involved five conditions we call CBABE (CF, Bronchieastasis, Asthma, Bronchitis Chronic & Emphysema ). Contemporary definitions differ from person to person however.

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Actually, I've for a long time believed chronic asthma to be in the COPD family as well. But I only came to understand that after having nearly the same conversation with a nurse, only this one was in the ER.

What does COPD stand for?

What is asthma?

Why does chronic asthma not fit?

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I can easily understand how COPD and asthma can fit into the same category. But they both have different treatment. so, actually saying that COPD is the same thing as asthma can be a medical error and lead to a wrong diagnosis and medication. I've notice a lot of RN in nursing home really just wanna get the PT out and usually don't give us a full or proper report. They are both so similar in many ways but COPD usually starts over the age of 40 meanwhile, asthma can begin at an early age. <-- from what I read.

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What does COPD stand for?

What is asthma?

Why does chronic asthma not fit?

See i dig that, but when i get to the differences between the obstruction from emphysema and the obstruction form asthma clearly there is a difference in the physiology. Damage to alveolar septal wall / acini / parenchyma in emphysema than asthma, so to me asthma and chronic bronchitis are far more similar than asthma and the "broad" name of COPD.

Whihc brings me to the next crazy idea.... perhaps its emphysema that is the odd on out here

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