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That's my read on it too. Interesting EKG though. The rate, especially early on in the first 12 is a bit concerning, especially considering he was just symptomatic.

For sure, I was thinking about the structural changes and pressure changes as well, but everything I could think of would be contradictory in this ECG so although probably there, I think they are completely over written by the changes due to the effects above (described in my other post) and any...

I'm with Brandon on this one. These ECG's read identically, just like the monitor says. Remember that reading an ECG is not about pattern recognition. Just because the patterns of the tracings don't look like the same thing doesn't mean that the ECG's don't read the same. First off, rhythm...

Nova1300: I don't mean to be short with you but I just feel like you are asking redundant questions that have been the topic of this entire thread. I feel like you think I have a specific reason for thinking that we should include this issue with these pathology's into the Paramedic...

I just saw that you underlined that line in your quote of my entire post, I didn't re-read my own post.... Regardless, my point above stands, what's your point?

You expected me to know that "why" was in reference to that one statement in my multi-paragraph post. And then reply "Ok." as if I'm stupid for asking what "why" meant. Give me a break with your disingenuous games. If you have a point, feel free to make it... I don't have time to play games...

I don't follow your question.

Hey Brandon, great discussion for sure! I'm sorry but I fail to see the point in your post. You keep coming back to this idea of if it doesn't change your treatment it must be useless. I don't know how else to explain to you what I consider the value of the knowledge in the pathophysiology. I...

" The various disorders that cause chronic airway obstruction have a different natural history, response to treatment and prognosis. Therfore, it is important to recognise them as distinct entities not only for the purpose of discussion but also for clinical management and research. " OK am I...

I found the article that led me to researching this, sorry I've been looking for it for a while and just found it! It's called Chronic Obstructive Pulmonary Disease: Knowing What We Mean, Meaning What We Say J.M. Joshi Department of Respiratory Medicine, T.N. Medical College and B.Y.L. Nair...

This was an accidental post but I want to add: Chronic Bronchitis is a disease that is diagnosed based of the patients history only. Emphysema is diagnosed by observing structural changes in the anatomy of the lung they are literally completely different physical things caused by a common origin.

I'm saying that there is more to clinical relevance than what treatment protocol you follow. That's the definition of cook book medicine. I agree that they have many similarities, that's why I made the PSVT analogy. The point is arguing against a deeper understanind of the pathophysiology and...

Yeah DEmedic is right here, EMS is so drastically different from one tow to the next that it's unreasonable to expect nurses to learn it without a lot of direct exposure. It's up to us to educate them with the tools he talked about. The fact of the matter is I would prefer the nurse ignorant of...

Let me try to describe this in a different way. I'm not trying to argue that these diseases only exist in a vacuum, although yes, some aspects of them are mutually exclusive. But they are also well differentiated enough that they should be easily discernible to a skilled clinician for instance I...

I have to say that's a really disappointing anti-intellectual argument DEmedic. If you will excuse me for answering a question with a question. Can you imagine a scenario where a deeper and better understanding of this wouldn't help a prehospital provider? I HATE the "well, I don't need to know...

Yes, I have. I do not agree with you at all. These disease processes are in actuality drastically different processes and rarely overlap. In fact some of the changes are rather mutually exclusive. I'm going to go in to detail below. In "COPD" over a long period of time, and nearly all of the...

I have to disagree. Brandon, what you are talking about is very old thinking in medicine and there are very few similarities between the two. Although PT's with emphysema are at risk for bouts of bronchitis the disease process of chronic bronchitis and emphysema are completely different and...

It depends where you are for local protocol but it has become unpopular to include intrusion other than the passenger compartment. The idea that deformity elsewhere in the car was related to the amount of force exerted is outdated thinking of big cars with all steel frames and no crumple zones...

Ehhh, that's a tough question to answer beyond theoretically. I mean, with that level of disease, yes there is certainly air trapping. Not everyone compensates the same. Compensitory mechanisms like pursed lip breathing are in response to a specific thing, not just "aspects of a disease" if you...