Respiratory failure physical examination: Difference between revisions
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{{Respiratory failure}} | {{Respiratory failure}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}}{{HM}} | ||
==Overview== | ==Overview== | ||
Patients with respiratory failure usually appear distressed with altered mental status. Physical examination of patients with respiratory failure is usually remarkable for dyspnea, stridor, and tachypnea. | Patients with respiratory failure usually appear distressed with [[altered mental status]]. Physical examination of patients with respiratory failure is usually remarkable for [[dyspnea]], [[stridor]], and [[tachypnea]]. | ||
==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients with respiratory failure is as follows:<ref name="pmid10559098">{{cite journal |vauthors=Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA |title=Interobserver variability in applying a radiographic definition for ARDS |journal=Chest |volume=116 |issue=5 |pages=1347–53 |date=November 1999 |pmid=10559098 |doi= |url=}}</ref><ref name="pmid3298678">{{cite journal |vauthors=Gattinoni L, Presenti A, Torresin A, Baglioni S, Rivolta M, Rossi F, Scarani F, Marcolin R, Cappelletti G |title=Adult respiratory distress syndrome profiles by computed tomography |journal=J Thorac Imaging |volume=1 |issue=3 |pages=25–30 |date=July 1986 |pmid=3298678 |doi= |url=}}</ref> | |||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
Patients with respiratory failure usually appear distressed with altered mental status | Patients with respiratory failure usually appear distressed with [[altered mental status]] | ||
===Vital Signs=== | ===Vital Signs=== | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
*Arrhythmia | *[[Cardiac arrhythmia|Arrhythmia]] | ||
*Tachypnea | *[[Tachypnea]] | ||
===Skin=== | ===Skin=== | ||
*[[Cyanosis]] | *[[Cyanosis]] | ||
*Bruises | *[[Bruise|Bruises]] | ||
**May be due to insult to the neck or thorax | **May be due to insult to the neck or thorax | ||
*[[Clubbing]] | |||
*[[Rash|Rashes]] | |||
**May suggest [[atopy]] | |||
===HEENT=== | ===HEENT=== | ||
*Evidence of trauma | *Evidence of trauma | ||
*Ophthalmoscopic exam may be abnormal with findings of papilledema | *Ophthalmoscopic exam may be abnormal with findings of [[papilledema]] | ||
*Flared nares | *[[Accessory muscles of respiration|Flared nares]] | ||
*[[Nasal polyp|Nasal polyps]] | |||
**May suggest [[atopy]] or aspirin-induced asthma | |||
===Neck=== | ===Neck=== | ||
Bruises | *[[Bruise|Bruises]] | ||
*Elevated [[jugular venous pulse]] | |||
===Lungs=== | ===Lungs=== | ||
Fine [[crackles]] upon auscultation of the lung | *Fine [[crackles]] upon auscultation of the lung bases bilaterally | ||
*Evidence of preexisting lung disease may also be present such as: | |||
**Paradoxical thoraco-abdominal breathing | |||
**[[Wheeze]] | |||
***Typically absent and secondary to severe airway obstruction, representing a [[Status asthmaticus|silent chest]] | |||
**Persistent scattered rhonchi | |||
**Prolonged expiration | |||
**Diffusely decreased breath sound | |||
**Coarse crackles with inspiration | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
*Altered mental status | *[[Altered mental status]] | ||
*Clonus | *[[Clonus]] | ||
**May be present | |||
===Extremities=== | ===Extremities=== | ||
[[Cyanosis]] | *[[Cyanosis]] | ||
*Peripheral [[edema]] | |||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Pulmonology]] | |||
[[Category:Anesthesiology]] | |||
Latest revision as of 23:58, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Patients with respiratory failure usually appear distressed with altered mental status. Physical examination of patients with respiratory failure is usually remarkable for dyspnea, stridor, and tachypnea.
Physical Examination
Physical examination of patients with respiratory failure is as follows:[1][2]
Appearance of the Patient
Patients with respiratory failure usually appear distressed with altered mental status
Vital Signs
Skin
HEENT
- Evidence of trauma
- Ophthalmoscopic exam may be abnormal with findings of papilledema
- Flared nares
- Nasal polyps
- May suggest atopy or aspirin-induced asthma
Neck
- Bruises
- Elevated jugular venous pulse
Lungs
- Fine crackles upon auscultation of the lung bases bilaterally
- Evidence of preexisting lung disease may also be present such as:
- Paradoxical thoraco-abdominal breathing
- Wheeze
- Typically absent and secondary to severe airway obstruction, representing a silent chest
- Persistent scattered rhonchi
- Prolonged expiration
- Diffusely decreased breath sound
- Coarse crackles with inspiration
Neuromuscular
- Altered mental status
- Clonus
- May be present
Extremities
References
- ↑ Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA (November 1999). "Interobserver variability in applying a radiographic definition for ARDS". Chest. 116 (5): 1347–53. PMID 10559098.
- ↑ Gattinoni L, Presenti A, Torresin A, Baglioni S, Rivolta M, Rossi F, Scarani F, Marcolin R, Cappelletti G (July 1986). "Adult respiratory distress syndrome profiles by computed tomography". J Thorac Imaging. 1 (3): 25–30. PMID 3298678.