Something to tickle your brain.

[Kaisu]

Excellent post eb. Uncommon but not rare and grossly underdiagnosed. Consider my brain tickled

Edited July 31, 2012 by Kaisu

[EMTDenny]

Not to sound like a noob which I totally am but what is CF?

Edited July 31, 2012 by EMTB.Denny389

[DFIB]

Not to sound like a noob which I totally am but what is CF?

Cistic Fibrosis?

[monkadelic]

Hi first post, just recently started in EMS as a basic; just clarifying on the "nurse" saying that asthma was the same as COPD made me giggle a little bit; if it was in a nursing home it was most likely an CNA that made that statment imo. I may not have worked in EMS long, but I have been in an inpatient hospital setting and a patient transport for 5 years now, and i haven't heard of asthma triggering a hypoxic drive like COPD does. I think they are using it more of a "blanket term" more than anything.

[chbare]

How prevalent or relevant is this hypoxic drive theory?

[eb1040]

Hi first post, just recently started in EMS as a basic; just clarifying on the "nurse" saying that asthma was the same as COPD made me giggle a little bit; if it was in a nursing home it was most likely an CNA that made that statment imo. I may not have worked in EMS long, but I have been in an inpatient hospital setting and a patient transport for 5 years now, and i haven't heard of asthma triggering a hypoxic drive like COPD does. I think they are using it more of a "blanket term" more than anything.

If you look at a few of the recent COPD articles on the EMS info websites by some respected authors in the industry, you will see they still put Asthma in the same category as COPD in their discussion without specifically addressing differences. The similarities are more easily discussed especially for prehospital treatment.

Asthma will produce a similar response as the diseases associated now in the classification of COPD. But in both situations the term "hypoxic drive" is usually not the situation for the acute as once thought. Ventilation Perfusion inequality or mismatching and pulmonary vasocontriction have been among the accepted explanations along with a couple of other concepts or theories to explain the rise in Carbon Dioxide (CO2) and assoicated somnolence. There are also distinctions in Hypoxic Respiratory Failure and Hypercapnic Respiratory Failure which can be similar for Asthma and COPD although their pathophysiology deserves a more indepth understanding to appreciate the differences. Once this is understood in disease processes, it can be anticipated with the appropriate treatment ready and not feared. They hypoxic drive was also poorly explained in many allied healthcare and nursing textbooks for years like it was an on/off switch without any explanation of pH and only a vague overview of the chemoreceptors. This includes nursing, RTs and EMTs. Many, as seen in this discussion, may only have gotten a very general overview of both COPD and Asthma to where the differences are not fully noted or understood. Treatment may sometimes be provided in a shotgun style and sometimes there are situations where both diseases are present as well as a situation where one is not well recognized or treated because of the predominant facotrs of the other.

Edited August 1, 2012 by eb1040

[ERDoc]

The real definition of COPD has changed over the years. Classically, COPD has been a blanket term for emphysema, asthma and chronic bronchitis. These are all chronic conditions that lead to pulmonary obstruction (as opposed to a restrictive lung disease). Here is a great article from emedicine to help clear the air.

http://emedicine.medscape.com/article/297664-overview

I'd caution those who criticize others to be sure they know what they are talking about before blasting someone else, especially if you are new to the field. Just because someone works in a nursing home/long term care facility does not mean they are stupid and don't know what they are talking about.