Shortness of breath resident survival guide: Difference between revisions
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==Overview== | ==Overview== | ||
Dyspnea is | Dyspnea is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.”<ref name="pmid9872857">{{cite journal| author=| title=Dyspnea. Mechanisms, assessment, and management: a consensus statement. American Thoracic Society. | journal=Am J Respir Crit Care Med | year= 1999 | volume= 159 | issue= 1 | pages= 321-40 | pmid=9872857 | doi=10.1164/ajrccm.159.1.ats898 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9872857 }} </ref> | ||
Because dyspnea is a symptom (i.e., perception of an abnormal or distressing internal state), it must generally be distinguished from signs that clinicians typically invoke as evidence of respiratory distress, such as tachypnea, use of accessory muscles, and intercostal retractions.<ref name="pmid18370892">{{cite journal| author=Campbell ML| title=Psychometric testing of a respiratory distress observation scale. | journal=J Palliat Med | year= 2008 | volume= 11 | issue= 1 | pages= 44-50 | pmid=18370892 | doi=10.1089/jpm.2007.0090 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18370892 }} </ref | Because dyspnea is a symptom (i.e., perception of an abnormal or distressing internal state), it must generally be distinguished from signs that clinicians typically invoke as evidence of respiratory distress, such as tachypnea, use of accessory muscles, and intercostal retractions.<ref name="pmid18370892">{{cite journal| author=Campbell ML| title=Psychometric testing of a respiratory distress observation scale. | journal=J Palliat Med | year= 2008 | volume= 11 | issue= 1 | pages= 44-50 | pmid=18370892 | doi=10.1089/jpm.2007.0090 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18370892 }} </ref> | ||
Respiratory discomfort may arise from a wide range of clinical conditions, but also may be a manifestation of poor cardiovascular fitness in our increasingly sedentary population. Diagnosis and treatment of the underlying cause of dyspnea is the preferred and most direct approach to ameliorating this symptom, but there are many patients for whom the cause is unclear or for whom dyspnea persists despite optimal treatment.<ref name="pmid9211476">{{cite journal| author=Desbiens NA, Mueller-Rizner N, Connors AF, Wenger NS| title=The relationship of nausea and dyspnea to pain in seriously ill patients. | journal=Pain | year= 1997 | volume= 71 | issue= 2 | pages= 149-56 | pmid=9211476 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9211476 }} </ref> | |||
==Causes== | ==Causes== | ||
Revision as of 15:42, 3 March 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Steven Bellm, M.D. [2]
| Shortness of breath resident survival guide Microchapters |
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| Overview |
| Classification |
| Causes |
| FIRE |
| Diagnosis |
| Treatment |
| Do's |
| Dont's |
Overview
Dyspnea is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.”[1] Because dyspnea is a symptom (i.e., perception of an abnormal or distressing internal state), it must generally be distinguished from signs that clinicians typically invoke as evidence of respiratory distress, such as tachypnea, use of accessory muscles, and intercostal retractions.[2]
Respiratory discomfort may arise from a wide range of clinical conditions, but also may be a manifestation of poor cardiovascular fitness in our increasingly sedentary population. Diagnosis and treatment of the underlying cause of dyspnea is the preferred and most direct approach to ameliorating this symptom, but there are many patients for whom the cause is unclear or for whom dyspnea persists despite optimal treatment.[3]
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
FIRE
A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention.
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Complete Diagnostic Approach
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Treatment
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hidden
Do's
Dont's
References
- ↑ "Dyspnea. Mechanisms, assessment, and management: a consensus statement. American Thoracic Society". Am J Respir Crit Care Med. 159 (1): 321–40. 1999. doi:10.1164/ajrccm.159.1.ats898. PMID 9872857.
- ↑ Campbell ML (2008). "Psychometric testing of a respiratory distress observation scale". J Palliat Med. 11 (1): 44–50. doi:10.1089/jpm.2007.0090. PMID 18370892.
- ↑ Desbiens NA, Mueller-Rizner N, Connors AF, Wenger NS (1997). "The relationship of nausea and dyspnea to pain in seriously ill patients". Pain. 71 (2): 149–56. PMID 9211476.