In this two-part series I discuss asthma and COPD. These diseases are complex and have a spectrum of severity and presentation. The sickest of these patients require prompt, aggressive care to prevent further deterioration so a thorough understanding of the disease is essential. Michael Perlmutter, flight/critical care paramedic and medical student, joins me for a great conversation on prehospital management of these diseases. This is Part I which covers pathophysiology, diagnosis, and early management. Part II will be released in a couple weeks and will cover treatments used in our more critical patients and advanced stages of exacerbations. As always, please follow us on our various social media accounts and let me know if you have any questions, feedback, or personal experiences to share.


Note: in the podcast at one point I say ipratropium and tiotropium are muscarinics but they are muscarinic antagonists.


Facebook: https://www.facebook.com/paramedicpractitioner/
Instagram: @paramedicpractitioner
Email: amerelman@gmail.com
Twitter: @amerelman

Below are some quick guides to home management of asthma and COPD. The treatment approaches between the two diseases vary. One of the biggest differences is that asthma patients are started on inhaled steroids relatively early in their progression but if you see a patient with COPD on an inhaled steroid, they are likely late in their disease process. By looking at a patient’s home medications you can infer some information about the severity and pathophysiology of their underlying disease.

Image: PulmCrit

References:

References
UpToDate
https://emedicine.medscape.com/article/296301-overview
https://canadiem.org/management-of-severe-asthma/
http://www.emdocs.net/critical-asthma-patient-pearlspitfalls-of-management/
https://rebelem.com/rebelcast-crashing-asthmatic/
https://emcrit.org/ibcc/asthma/
https://asthma.net/treatment/prevention/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157154/
https://www.ncbi.nlm.nih.gov/books/NBK430901/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434661/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169834/
https://www.ncbi.nlm.nih.gov/pubmed/23235634
https://www.ncbi.nlm.nih.gov/pubmed/22479740

The Paramedic Practitioner © 2019