When Breathing Goes Bad (Asthma)

[VentMedic]

At this point in the game I am interested in the principles of respiratory care and having a firm understanding of the pathophysiology and assessment and treatment of breathing disorders as a Paramedic, not an RRT. A lot of what your talking about takes years of experience and additional education to grasp.

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A Paramedic's job in the 20mins or so they have a patient is to stabilize them, give them relief, and get them to the hospital in better shape than they found them. Its up to the physicians to dx and the RN's and RRT's to do 3/4 of what you say we should be considering.

So does that mean you do not need to understand the pathophysiology of a disease or what/why something happens when you apply O2 or give a med other than what an EMT or Paramedic text gives you?

Actually most of what I have been writing about is RT 101. I haven't even begun to get into differentials, labs, CXR, Stages or any of what fills volumes of just Pulmonary diseases for kids.

 

[ResTech]

I am interested in the principles of respiratory care and having a firm understanding of the pathophysiology and assessment and treatment of breathing disorders as a Paramedic, not an RRT

The above quote answers your question In fact I have been driving myself crazy trying to understand it in depth. 3/4 of what I have been studying is above what is contained in the textbook and comes from other resources. But it is all relevant to my role as a Paramedic, not an RRT, or something else that I am not endeavoring to become.

While your knowledge is very much appreciated, I have noticed you try to exert RRT knowledge as the basics of Paramedic care. What an RRT does in the hospital is not always applicable or even matter out in the field. I know u will argue that but I believe that to be true.

I think it would be more beneficial (since this is an EMS based forum and not RRT) if we could focus more on modalities and care that is pertinent to the pre-hospital environment and crucial to Paramedic care.... especially for the many Students that are on here who need to crawl before they can walk so to speak.

 

[VentMedic]

Again, my explanations are 1st semester RT and actually should not be beyond the grasp of some who have had college level A&P. I have not even begun to dwell into what I cover indepth in classes beyond a 1st semester RT. In fact, what I am writing is more of what I cover in a nursing student's class which I find to be totally inadequate but none the less what they allow time for.

If I am writing beyond what you are comprehending now, that should be incentive to learn more and to realize how much more there is to know. Too many get an EMT or Paramedic cert and believe that is all there is to medicine. Thus we have threads like the recent one that stated RNs and Paramedics were essentially the same.

I have many years of advance education as does Rid. Yet, both of us have continued to emphasize we learn something new almost every day and don't for one minute believe we know all about everything.

 

[ResTech]

incase we inadvertently close the ductus in a ductal dependent lesion such as seen in cyanotic heart disease.

the Oxyhemoglobin Dissociation Curve for PaO2

This is not entry-level Paramedic stuff.

In the hospital, you have access to the patients test results and can converse direct with the doc to know more of what is going on. In the field we don't have that option. We cant perform a definitive dx to guide treatment or have diagnostic tests to play off of. Which is why EMS is to stabilize and transport, not diagnose. And not to mention in the hospital you have an entire shift to provide care and follow-up... EMS doesn't have that luxury. T

If I have a patient who cant breathe, my goals are two-fold. Ensure oxygenation and ventilation with the tools and meds I have access to and am knowledgeable to use... and to use them effectively until I get my patient to the hospital. Im not gonna be thinking about blood tests, and need to get a chest x-ray, and do this pulmonary test or this and that study. I agree it is crucial to be able to perform a differential dx, however.

 

[ResTech]

If I am writing beyond what you are comprehending now, that should be incentive to learn more

It is incentive and learning is awesome and something I really get off on... Im just trying to get across that Paramedic's are not RRT's and should not be penalized for not knowing something taught in RRT school. The same is also true of the RRT. They should not be penalized for not knowing how to read a 12-lead or treat a trauma patient.

 

[VentMedic]

It is incentive and learning is awesome and something I really get off on... Im just trying to get across that Paramedic's are not RRT's and should not be penalized for not knowing something taught in RRT school. The same is also true of the RRT. They should not be penalized for not knowing how to read a 12-lead or treat a trauma patient.

Nobody is penalizing you.

As well, there are forum members from Canada, Australia and New Zealand who join into the conversations. Many of them have a 4 year degree to be a Paramedic. When they join in the conversation can seriously be taken to a different level than what American EMT(P)s are accustomed to. I do not see that as a bad thing since the American EMT(P) has spent 40 years focused on skills and very little on education.

As you already know, I will try to explain things a different way or refer to a source for more reading.

 

[VentMedic]

One more little comment along this thought of being too much for the Paramedic. I have seen many on this forum use the initials CCEMT-P with their name. They may be responsible for managing a ventilator or some continuous neb of various meds during transport. Should they not know a little more than what knob to turn or just allow the RN or RRT at the hospital to set up all their meds and equipment for the transport? Then, all the American Paramedic has to do is watch the med go drip, drip, drip without knowing anything about it or doing anything with it.

 

[ResTech]

Maybe the inadequacy of the current Paramedic curriculum is the source of my frustration. I got "A"'s in every one of my classes last semester and still, I feel there is a lot of void due to so much not being covered. Which is why I have spent so much time over this Summer reading and trying to fill in the voids and doing the optional field clinicals over the Summer as well.

I am trying right now to have a good grasp on each of the most commonly encountered resp disorders. Once I master that than I will feel comfortable moving forward.

Its all very frustrating!

 

[Sasha]

Maybe the inadequacy of the current Paramedic curriculum is the source of my frustration. I got "A"'s in every one of my classes last semester and still, I feel there is a lot of void due to so much not being covered. Which is why I have spent so much time over this Summer reading and trying to fill in the voids and doing the optional field clinicals over the Summer as well.

I am trying right now to have a good grasp on each of the most commonly encountered resp disorders. Once I master that than I will feel comfortable moving forward.

Its all very frustrating!

Then why are you fighting when people try to educate you? You seem very unreceptive to help and want to get by with bare minimum required.

 

[ResTech]

If I wanted to get by with the bare minimum I wouldnt be spending my Summer doing optional time on a Paramedic unit and studying my *** off just to make sure I fully understand.

I know I've mastered the minimum knowledge and skills from last semester... if I was happy with that I would let it go and not worry ne more about it. For me, a perfectionist, there are a lot of blanks which is what I am striving to fill.

That is far from a bare minimum approach dont ya think.

 

[Sasha]

If I wanted to get by with the bare minimum I wouldnt be spending my Summer doing optional time on a Paramedic unit and studying my *** off just to make sure I fully understand.

I know I've mastered the minimum knowledge and skills from last semester... if I was happy with that I would let it go and not worry ne more about it. For me, a perfectionist, there are a lot of blanks which is what I am striving to fill.

That is far from a bare minimum approach dont ya think.

If you weren't going for bare minimum, you would be more receptive to other people trying to educate you, dont ya think?

 

[ResTech]

Your right... I'm all about bare minimum. All "A"'s, about 300 optional clinical hours over Summer, and still studying my *** off despite being on Summer break... I'm definitely bare minimum.

I'm just curious... how come you dont ever engage in any discussion of a clinical nature and only offer tid bit posts?

 

[Sasha]

Your right... I'm all about bare minimum. All "A"'s, about 300 optional clinical hours over Summer, and still studying my *** off despite being on Summer break... I'm definitely bare minimum.

I'm just curious... how come you dont ever engage in any discussion of a clinical nature and only offer tid bit posts?

Because when I do some people like to argue insiginficant and wrong points, so I'd rather sit back and learn. Which is what I do, even if what people are talking about is something I may never run into on a truck. I like the education. I'm GLAD Vent posts above and beyond the paramedic scope, when she does. It makes some other things falls into place, leads to google learning and a better understanding of my patients.

So if you don't like it, grin and bear it, or skip it but don't nag at her and ruin it for the rest of us who enjoy reading her posts and learning from them.

 

[medic417]

Quote:
incase we inadvertently close the ductus in a ductal dependent lesion such as seen in cyanotic heart disease.

Quote:
the Oxyhemoglobin Dissociation Curve for PaO2

This is not entry-level Paramedic stuff.

If your school is not teaching these items especially the curve I have to wonder how good they actually are.

I commend you though for pursuing more on your own.

 

[VentMedic]

Quote:
incase we inadvertently close the ductus in a ductal dependent lesion such as seen in cyanotic heart disease.

Quote:
the Oxyhemoglobin Dissociation Curve for PaO2

No EMT or Paramedic should be given a Pulse Oximeter without having some knowledge of the Oxyhemoglobin Dissociation Curve.

No Paramedic clinical should be done in a NICU without some baseline knowledge of neonatal disorders. The NICU is not for "well babies" who had normal uncomplicated deliveries and have no medical problems.

At least he is making the effort to get more knowledge. However, I hope some see where these things would come so much easier with college level A&P, Pathophysiology and Pharmacology as prerequsites for a Paramedic class. Sometimes just the short blurp given in an EMT or Paramedic can give one the feeling that they know all there is to know. It is also like just reading one small blip in a huge textbook, an over simplified article in JEMS or on the internet. One doesn't really get the broad picture and that can lead to a lot of misconceptions and misinformation.

 

[reaper]

So, you can take the FREE education into a much further advanced stage of Respiratory problems, or you can feel free to be a cookbook medic. If you only worry about learning what you think you will see as a medic, your Pt's will suffer for it. Read what she is trying to teach you and ask questions, if you do not understand something.

In 20 years, I have continued to learn something new, almost everyday. A lot of that new knowledge has come from Vent and the time she takes to educate us on things that may not be common on the streets, but you will run into!

If you do not want to learn it, just don't read it! Some of us are grateful for the advanced info she brings to the forum.

 

[VentMedic]

If you do not want to learn it, just don't read it!

Yeah I'm on a few ignore lists.