Acute dyspnea: Difference between revisions
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*#Tension [[PNTX]] | *#Tension [[PNTX]] | ||
*#[[Cardiac Tamponade]] | *#[[Cardiac Tamponade]] | ||
*#[[Flail | *#[[Flail Chest]] | ||
*#[[CO Poisoning]] | *#[[CO Poisoning]] | ||
*#Abd distension | *#Abd distension | ||
Revision as of 04:07, 25 March 2014
Workup
- CXR
- ECG
- CBC
- Chem-7
- BNP?
- D-dimer?
- Troponin?
- ABG?
Diagnosis
Emergent Pattern Recognition
- Pulmonary edema
- lungs: b/l rales
- CXR: interstitial fluid
- Tx: ECG (R/O AMI), lasix, nitrates, ACE, BIPAP
- Bronchoconstriction
- lungs: wheezes
- CXR: neg/hyperinflated
- Tx: albuterol, atrovent, steroids, consider anaphylaxis (epi)
- Pneumonia
- lungs: focal ronchi/dec BS
- CXR: infiltrate/effusion
- Tx: abx
- PE
- lungs: clear
- CXR: clear/Westrmrk/Hmptn
- Tx: ECG, D-dimer and/or CT; anticoagulate/thrombolytics
- Pneumothorax/Hemothorax
- lungs: unequal
- CXR: pneumo/hemo
- Tx: needle/chest-tube
- Dysrythmia
- lungs: clear/pulm edema
- CXR: clear/pulm edema
- ECG: abnl
- Tx: rate dependent
- Cardiac Ischemia
- lungs: clear/pulm edema
- CXR: clear/pulm edema
- ECG: nl/abnl
- Tx: B-block, nitrates, anticoag, +/- thrombolytics
DDX
EMERGENT
- Pulmonary
- Airway obstruction
- PE
- Noncardiogenic edema
- Anaphylaxis
- Spont pneumothorax
- Asthma
- Cor pulmonale
- Aspiration
- PNA
- Cardiac
- Other Associated with Nl/Increased Resp Effort
- Toxic Ingestion
- DKA
- Epiglotitis
- Tension PNTX
- Cardiac Tamponade
- Flail Chest
- CO Poisoning
- Abd distension
- Sepsis
- Hypotension
- Renal Failure
- Electrolyte Abnormality
- Metabolic Acidosis
- PNA
- Pneumothorax/hemothorax
- Diaphragmatic rupture
- Anemia
- Other Associated with Decreased Resp Effort
- CVA
- Organophosphate Poisoning
- MS
- Guillian-Barre
- Tick paralysis
Non-Emergent
- Pleural effusion
- Neoplam
- PNA
- COPD
- Congenital Heart Disease
- Pregnancy
- Ascites
- Obesity
- Hypterventilation
- Panic attack
- Fever
- Thyroid Disease
- Rib fx
- ALS
- Polymyositis
- Porphyria
Source
- Rosen