Dyspnea resident survival guide: Difference between revisions
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A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention. | A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention. | ||
{{ | {{Family tree/start |summary=FIRE algorithm for Dyspnea}} | ||
{{ | {{Family tree | | | | | | | A01 | | | |A01=<div style="float: left; text-align: left; width: 12em; padding:1em;"> '''Rapid assessment'''<br> | ||
❑ Circulation <br>❑ Airway <br>❑ Breathing </div>}} | ❑ Circulation <br>❑ Airway <br>❑ Breathing </div>}} | ||
{{Family tree | | | | |!| | | | | }} | {{Family tree | | | | | | | |!| | | | | }} | ||
{{Family tree | | | | | {{Family tree | | | | | | | B01 | B01=Is the patient in acute cardiopulmonary arrest}} | ||
{{Family tree | |,|-|-|^ | {{Family tree | | | | |,|-|-|^|-|.| | }} | ||
{{Family tree | C01 | | | | | {{Family tree | | | | C01 | | | C02 |-|-|-| C03 | | | |C01=No|C02=Yes|C03=Activate [[ACLS|ACLS algorithm]]}} | ||
{{Family tree | | | | |!| | | | | | | | }} | |||
{{Family tree | | | | D01 | | | | |D01=<div style="float: left; text-align: left; width: 26em; padding:1em;"> '''Does the patient have any of the following signs and symptoms that require urgent management'''<br> | |||
❑ Altered mental status <br>❑ Abnormal vital signs <br> | |||
:❑ Fever<br> | |||
:❑ Hypothermia<br> | |||
:❑ Tachycardia<br> | |||
:❑ Bradycardia<br> | |||
:❑ Hypotension<br> | |||
:❑ Tachypnea<br> | |||
:❑ Hypopnea<br> | |||
:❑ Hypoxia<br> | |||
❑ Fever<br>❑ Wheezes <br>❑ Crackles <br>❑ Jugular venous distension <br>❑ >❑ Stridor <br>❑ Tracheal deviation <br>❑ Absent breath sounds <br> ❑ Distant heart sounds </div>}} | |||
{{Family tree | | | |,|^|-|-|.|}} | |||
{{Family tree | | | E01 | | E02 |-|-|-|-| E03 |E01=Yes|E02=No|E03=[[Diagnosis|Continue with complete diagnostic approach below]]}} | |||
{{Family tree | | | |!| | | | | | | |}} | |||
{{Family tree | | | F01 | | | | |F01=<div style="float: left; text-align: left; width: 12em; padding:1em;"> '''Order stat tests'''<br> | |||
❑ CBC <br>❑ CMP <br>❑ D-dimer <br>❑ Cardiac enzymes <br>❑ NT-proBNP <br>❑ ABG <br>❑ Blood Cultures (fever) <br>❑ CXR <br>❑ EKG </div>}} | |||
{{Family tree/end}} | {{Family tree/end}} | ||
Revision as of 16:41, 27 April 2014
| 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
- 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.
Rapid assessment ❑ Circulation ❑ Airway ❑ Breathing | |||||||||||||||||||||||||||||||||||||||
| Is the patient in acute cardiopulmonary arrest | |||||||||||||||||||||||||||||||||||||||
| No | Yes | Activate ACLS algorithm | |||||||||||||||||||||||||||||||||||||
Does the patient have any of the following signs and symptoms that require urgent management ❑ Altered mental status
❑ Wheezes ❑ Crackles ❑ Jugular venous distension ❑ >❑ Stridor ❑ Tracheal deviation ❑ Absent breath sounds ❑ Distant heart sounds | |||||||||||||||||||||||||||||||||||||||
| Yes | No | Continue with complete diagnostic approach below | |||||||||||||||||||||||||||||||||||||
Order stat tests ❑ CBC ❑ CMP ❑ D-dimer ❑ Cardiac enzymes ❑ NT-proBNP ❑ ABG ❑ Blood Cultures (fever) ❑ CXR ❑ EKG | |||||||||||||||||||||||||||||||||||||||
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