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It seems pretty obvious that part of the gap between the way docs generally think and the way medics generally think is a result of their respective educations:  medical school is long on theory and kind of short on the mechanics of actual day in, day out healthcare practice; paramedic school seems to be the opposite.

Today, a doc was lecturing us medical students about asthma, and he described a scenario with which he’d been faced several years ago:  responding to an asthma attack on a commercial airline flight; the patient had forgotten her rescue inhaler.  (”You’d think on a flight with hundreds of people, more than one would be a doctor.  But it was just me.”)  He opened up the medical kit and found a BP cuff, stethoscope, and one ampule each of two medications:  epinephrine and Valium.  (Why just those two, I’ll never know for sure, but can guess.  Things have gotten much better since then.)  The instructor asked what we would do.

It’s not immensely difficult to come up with exactly what the doctor did:  figure out who else on the plane had asthma, had brought a rescue inhaler, and didn’t mind sharing.  We also discussed injecting the epi.  Then, a couple of my classmates thought up the bright idea to deliver the epi straight to the patient’s lungs.

The doc conceded he wasn’t sure how effective that would be outside of an arrest situation.  (It would work beautifully:  epi is the active ingredient in Primatene Mist.)  However, while the theory was great, every medic out there is already thinking the same thought:  in a kit so poorly equipped, what piece of equipment could you possibly to use to deliver the epi to anything other than the back of the throat?

Filed under: EMS