Dyspnea resident survival guide

Dyspnea Resident Survival Guide Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Milan C. Mathew, M.D., M.P.H. [2]

Overview

Dyspnea is the uncomfortable awareness of one's own breathing. It is a common symptom of numerous medical disorders.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

• Acute heart failure
• Acute coronary syndrome
• Acute papillary muscle rupture
• Acute respiratory distress syndrome
• Anaphylaxis
• Aortic dissection
• Bronchospasm
• Cardiac tamponade
• Foreign body aspiration
• Glottic edema
• Pneumothorax
• Pneumonia
• Pulmonary embolism
• Pulmonary edema

Common Causes

• Acute heart failure
• Acute coronary syndrome
• Asthma
• Anemia
• COPD
• Interstitial lung disease
• Pulmonary embolism
• Pneumonia
• Respiratory tract infection

Click here for the complete list of causes.

FIRE: Focused Initial Rapid Evaluation

A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention.

Does the patient have any of the following signs and symptoms that require urgent management ❑ Altered mental status ❑ Abnormal vital signs ❑ Fever ❑ Hypothermia ❑ Tachycardia ❑ Bradycardia ❑ Hypotension ❑ Tachypnea ❑ Hypopnea ❑ Hypoxia ❑ Wheezes ❑ Crackles ❑ Jugular venous distension ❑ Stridor ❑ Tracheal deviation ❑ Absent breath sounds ❑ Distant heart sounds

Yes

No

Continue with comprehensive diagnostic approach below

Order stat tests ❑ CBC ❑ CMP ❑ D-dimer ❑ Cardiac enzymes ❑ NT-proBNP ❑ ABG ❑ Blood cultures (fever) ❑ CXR ❑ EKG

Acute heart failure

Acute coronary syndrome

Acute respiratory distress syndrome

Anaphylaxis

Aortic dissection

Cardiac tamponade

Aspiration

Pneumothorax

Pulmonary embolism

Pneumonia

Asthma

COPD

Complete Diagnostic Approach

A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention

Do's

Don'ts

References