Something to tickle your brain.

[paramedicmike]

Glad I read all of the posts before responding as my comments would have been similar to CHBARE.

I'd also caution against grouping medical conditions based on their treatments. Just because treatments are different has nothing to do with classification of disease processes.

[chbare]

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.

I'm not sure you understand the concept of COPD. COPD is a constellation of issues, that means COPD is a broad term that could include a number of issues. If somebody has a history of COPD, it's your job to identify what type. Also remember COPD is not isolated to older people as certain conditions such as CF are often diagnosed during childhood. Identifying the type of COPD can be challenging as the specific pathologies cross over. Even performing pulmonary function tests may not yield an answer as airflow obstruction and gas trapping are common to most types of COPD. Sometimes you catch issues like emphysema when appreciating the Carbon monoxide diffusion test however.

COPD is just a ballpark term and it is your job to put the detective hat on and try to differentiate based on a good history and exam. Asking about triggers, mucous production, history of infections and so on is helpful. Unfortunately, you may not definitively identify the problem at the end of the day, but your therapy will be based on the clinical exam. You have wheezing, increased WOB, prolonged expiratory phase and so on, you will likely administer a Beta agonist regardless of the actual diagnosis.

[EMTDenny]

Chbare, I've never looked at it from that point of view. Good reply, I may need to look up and read more about COPD.

[Kaisu]

Asthma is an autoimmune disorder - a reactive airway disease. Its present from birth - although symptoms take awhile - and symptoms often disappear due to increase in the size of the airway.

COPD - emphysema and chronic bronchitis are acquired through a pathophysiological process - destruction of alveoli in the one, increased production of mucus secreting cells in the second and accompanying airway inflammation in response to irritation.

Asthma you are born with - COPD you get - usually after asking for it for decades.

Edited July 30, 2012 by Kaisu

[chbare]

Most people are born with CF as it is a genetic disorder.

[Kaisu]

Most people are born with CF as it is a genetic disorder.

True. Have never run on a CF patient, so forgot about them.

[Arctickat]

COPD is a catch all for a respiratory obstructive disease. Air is trapped in the lungs on a chronic basis. That's why they have normally low sats. During the acute phase the air trapped by secretions or emphysema can not be exhaled as easily, therefore the patient in the acute phase has lungs that are so full of air that he can not inhale any more.

Asthma is a restrictive disease, during the acute phase the bronchioles become inflamed and restrict air entry into the alveolae,

[chbare]

Restrictive disease is typically classified as pathology that involves the ability for the lungs and chest wall to expand. This is due to increased elastance or decreased compliance (one and the same). Restrictive pathology includes conditions such as ARDS, IRDS, pulmonary fibrosis, chest wall burns, abdominal compartment syndrome and obesity. Asthma is not typically thought of as restrictive pathology as the actual compliance of the lung parenchyma is not a problem but rather inflammation, spasm and mucus production leading to airway obstruction.

[Arctickat]

Hmm, you mean I was taught incorrectly? Grrrrrrr.

[eb1040]

Asthma you are born with - COPD you get - usually after asking for it for decades.

There is COPD - Emphysema from Alpha - 1 Antitripsin defiiciency which often goes misdiagnosed since the person does not smoke or is exposed to smoke.

The data is still coming in from BPD and its affects in adult life.