Acute dyspnea: Difference between revisions
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# ECG | # ECG | ||
# CBC | # CBC | ||
# Chem 7 | # Chem-7 | ||
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==Diagnosis== | ==Diagnosis== | ||
===Emergent Pattern | ===Emergent Pattern Recognition=== | ||
#Pulmonary edema | #Pulmonary edema | ||
#*lungs: bilat rales | #*lungs: bilat rales |
Revision as of 17:14, 20 May 2013
Workup
- CXR
- ECG
- CBC
- Chem-7
Consider:
- BNP
- D-dimer
- Troponin
- ABG
Diagnosis
Emergent Pattern Recognition
- Pulmonary edema
- lungs: bilat 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 (antihistamines, epi)
- Pneumonia
- lungs: focal ronchi/dec BS
- CXR: infiltrate/effusion
- Tx: abx, goal directed,
- PE
- lungs: clear
- CXR: clear/Westrmrk/Hmptn
- Tx: ECG, D-dimer and/or spiral CT; anticoagulate/thrombolise
- Pneumo/Hemo-Thorax
- 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, +/- thrombolitics
DDX
EMERGENT
- Pulmonary
- Airway obstruction
- PE
- Noncardiogenic edema
- Anaphylaxis
- Spont pneumothorax
- Asthma
- Cor pulmonale
- Aspiration
- PNA
- Cardiac
- Pulmonary edema (CHF)
- MI
- Cardiac tamponade
- Pericarditis
- 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 abnl
- Metabolic acidosis
- PNA
- Pneumo/hemo-thorax
- 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 dz
- Pregnancy
- Ascites
- Obesity
- Hypterventilation
- Panic attack
- Fever
- Thyroid dz
- Rib fx
- ALS
- Polymyositis
- Porphyria
Source
3/7/06 DONALDSON (adapted from Rosen)