Acute dyspnea: Difference between revisions
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===Emergent Pattern Recognition=== | ===Emergent Pattern Recognition=== | ||
#Pulmonary edema | #Pulmonary edema | ||
#*lungs: | #*lungs: b/l rales | ||
#*CXR: interstitial fluid | #*CXR: interstitial fluid | ||
#*Tx: ECG (R/O AMI), lasix, nitrates, ACE, BIPAP | #*Tx: ECG (R/O AMI), lasix, nitrates, ACE, BIPAP | ||
| Line 20: | Line 20: | ||
#*lungs: wheezes | #*lungs: wheezes | ||
#*CXR: neg/hyperinflated | #*CXR: neg/hyperinflated | ||
#*Tx: albuterol, atrovent, steroids, consider anaphylaxis ( | #*Tx: albuterol, atrovent, steroids, consider anaphylaxis (epi) | ||
#Pneumonia | #Pneumonia | ||
#*lungs: focal ronchi/dec BS | #*lungs: focal ronchi/dec BS | ||
#*CXR: infiltrate/effusion | #*CXR: infiltrate/effusion | ||
#*Tx: abx | #*Tx: abx | ||
#PE | #PE | ||
#*lungs: clear | #*lungs: clear | ||
#*CXR: clear/Westrmrk/Hmptn | #*CXR: clear/Westrmrk/Hmptn | ||
#*Tx: ECG, D-dimer and/or | #*Tx: ECG, D-dimer and/or CT; anticoagulate/thrombolytics | ||
#Pneumo/ | #Pneumo/Hemothorax | ||
#*lungs: unequal | #*lungs: unequal | ||
#*CXR: pneumo/hemo | #*CXR: pneumo/hemo | ||
| Line 42: | Line 42: | ||
#*CXR: clear/pulm edema | #*CXR: clear/pulm edema | ||
#*ECG: nl/abnl | #*ECG: nl/abnl | ||
#*Tx: B-block, nitrates, anticoag, +/- | #*Tx: B-block, nitrates, anticoag, +/- thrombolytics | ||
==DDX== | ==DDX== | ||
Revision as of 17:19, 20 May 2013
Workup
- CXR
- ECG
- CBC
- Chem-7
Consider:
- 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
- Pneumo/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
- 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)