VitalNotes

Paramedic Thinking. Essential Ideas. One Page at a Time.

Obsidian Setup & Use Guide

Introduction

Obsidian is a free, powerful note-taking app that turns your notes into a second brain. It’s ideal for paramedic students who want to organize their knowledge, connect ideas, and study more deeply. It supports markdown, backlinks, and linking notes together—perfect for building understanding across directives, conditions, medications, and pathophysiology.

1. Installing Obsidian

Desktop (Recommended)

Mobile (Optional)

  • Available for both iOS and Android
  • Sync via Obsidian Sync (paid) or free cloud options (Dropbox, Google Drive, GitHub, etc.)

2. Create Your Vault

A “vault” is your personal Obsidian workspace.

  • Open Obsidian → Create New Vault
  • Name it something like: Paramedic Notes
  • Choose where to save it (recommend a cloud folder for backup)

3. Folder Structure for Paramedic Students

Organize your vault to reflect how you learn and study. Example structure:

📁 00_Home
📁 01_Directives
📁 02_Drugs
📁 03_Systems (e.g., Cardio, Neuro)
📁 04_Pathophysiology
📁 05_Case Studies
📁 06_Lab Notes
📁 07_Personal Zettelkasten
📁 Templates

4. Recommended Settings

Open Settings (gear icon) and adjust the following:

SettingRecommendationPurpose
Editor > Reading ViewEnabledEasy toggling between edit/preview
Files & Links > Default location for new notesSame folder as current fileKeeps your vault tidy
Core Plugins > Daily NotesEnabledUse for journaling/lab debriefs
Core Plugins > TemplatesEnabledStandardize your note formats
Core Plugins > BacklinksEnabledSee what other notes link to this one
Core Plugins > Graph ViewEnabledVisual map of your knowledge
Community Plugins (Optional)Periodic Notes, QuickAdd, CalendarProductivity & note enhancement

5. Note Types & Workflow

Use these three note types in your workflow:

Fleeting Notes

Quick thoughts, jotted ideas during class or shift
→ Example:
[[Quick Note - Trauma]]: "Need to clarify pelvic binder steps"

Literature/Class Notes

Structured notes from lectures, readings, or ALS PCS
→ Template:

**Source:** ALS PCS – Hypoglycemia  
**Tags:** #directive #hypoglycemia  
**Summary:**  
- Treat if BGL < 4.0 mmol/L  
- Oral glucose if GCS 14+  
- IV Dextrose or Glucagon if unable to swallow

**Key Points:**  
- Glucagon requires intact glycogen stores  
- Dextrose = preferred IV option

Permanent Notes (Zettelkasten Style)

Your own understanding, in your own words
→ One idea per note
→ Connected to other relevant notes

→ Example:

Title: [[Hypoglycemia as a Medical Directive Trigger]]

Hypoglycemia is a trigger for several medical directives. It must be ruled out or corrected before applying other treatments such as altered LOA, seizures, or cardiac arrest causes.
Linked to: [[Seizure Directive]], [[Cardiac Arrest Hx]], [[Dextrose]]

6. Templates to Use

Create a folder called Templates and save common formats there.

Directive Note Template

**Directive:**  
**Source:** ALS PCS  
**Indications:**  
**Contraindications:**  
**Treatment Summary:**  
**Patch Considerations:**  
**Linked Topics:** [[Glucagon]], [[Hypoglycemia]], [[Altered LOA]]

Drug Card Template

**Name:**  
**Classification:**  
**Indications:**  
**Contraindications:**  
**Dose:**  
**Mechanism of Action:**  
**Side Effects:**  
**Linked Directives:** [[ACS]], [[Cardiogenic Pulmonary Edema]]

7. Daily & Lab Use Suggestions

  • Use Daily Notes to reflect on labs, lectures, or cases
  • Summarize key takeaways after each class
  • After lab scenarios: create permanent notes for what you learned, not what happened

8. Linking Notes & Backlinks

  • Use [[ ]] to link one note to another E.g., in ACS note: Nitroglycerin is used if systolic BP > 100 [[Nitroglycerin]]
  • Check Backlinks to see what’s connected (this shows you relationships in your knowledge)

9. Graph View: Visualizing Your Learning

  • Open Graph View to see how interconnected your notes are
  • Weak areas show up as isolated dots → build connections!

10. Syncing and Backups

  • Local Only: Notes are saved as plain .md text files
  • Free Sync Options:
    • Use Dropbox, Google Drive, or GitHub for cloud backup
  • Paid Option: Obsidian Sync ($10/month) offers end-to-end encrypted vault syncing

11. Pro Tips for Success

  • Don’t copy-paste slides → rewrite in your own words
  • Use tags sparingly: e.g., #cardiology, #directive, #pharmacology
  • Use Zettelkasten-style permanent notes to generate understanding
  • Use Anki alongside Obsidian:
    • Create Anki cards directly from permanent notes
    • Use note content to generate cloze deletions or basic cards

12. Getting Started Today

  1. Install Obsidian
  2. Create a new vault: Paramedic Notes
  3. Create your first folder: 01_Directives
  4. Start with one directive (e.g., Hypoglycemia)
  5. Add a literature note from ALS PCS
  6. Write one permanent note with your own explanation
  7. Link it to relevant topics using [[ ]]

Conclusion

Obsidian gives you a long-term advantage over passive note-taking. Instead of scattered files and unread documents, you’ll have an interconnected network of real knowledge. Combined with daily Anki use, this system creates a memory foundation strong enough to pass exams and support you in the field.

I. Learning Foundations

Build a strong system for thinking, studying, and remembering in high-pressure fields.

II. Practical Application

Move from theory to field-ready practice. These tools help bridge simulation, lab, and real calls.

  • Scenario Days – Make Learning Stick
    How to get more from scenario practice using repetition, debriefs, and learning loops. Turn repetition into retention.
  • Mastering Directive Decision-Making
    A breakdown of how to use directives in real-time, with pattern recognition, logic triggers, and threshold thinking.
  • Reflecting Without Journaling
    Not everyone journals—this guide offers quick, low-resistance alternatives to build metacognition through regular reflection.
  • Lab Integration Guide
    Use lab sessions to build decision-making habits, not just check off skills. Includes scenario prep, debriefing, and error capture.

III. Clinical Reasoning

Develop clarity under pressure. These pages train your diagnostic eye, pattern sense, and mental workflow.

IV. Resources

Your support tools: guides, summaries, templates, and setup walkthroughs.

  • Summary
    Recap of the big ideas behind VitalNotes: learn reflectively, study actively, and build a system that supports decision-making under pressure.
  • Helpful Resources
    Downloadables and quick-reference tools: directive cue sheets, Anki decks, debrief templates, and scenario aids.
  • Anki Setup & Use Guide
    Step-by-step instructions for downloading, customizing, and optimizing Anki for long-term retention.
  • Obsidian Setup & Use Guide
    How to build a clinical note vault in Obsidian: folder structures, templates, and linking strategies.
  • Sources and References
    A list of research and literature that supports the methods taught in the blog, with commentary on their application to clinical learning.