Dyspnea resident survival guide: Difference between revisions

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==FIRE: Focused Initial Rapid Evaluation==
==FIRE: Focused Initial Rapid Evaluation==
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/start |summary=FIRE algorithm for Dyspnea}}
{{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>
{{Family tree | | | | A01 |A01=<div style="float: left; text-align: left; width: 24em; 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>
❑ Abnormal vital signs <br>
:❑ Fever<br>
:❑ Fever<br>
:❑ Hypothermia<br>
:❑ Hypothermia<br>
Line 71: Line 70:
:❑ Hypopnea<br>
:❑ Hypopnea<br>
:❑ Hypoxia<br>
:❑ Hypoxia<br>
❑ Wheezes <br>❑ Crackles <br>❑ Jugular venous distension <br>❑ Stridor <br>❑ Tracheal deviation <br>❑ Absent breath sounds <br> ❑ Distant heart sounds </div>}}
❑ Altered mental status <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 | |,|-|-|^|.|}}
{{Family tree | | | | | | | E01 | | E02 | | |E01=Yes|E02=No}}
{{Family tree | B01 | | B02 |-| B03 |B01=Yes|B02=No|B03=[[Diagnosis|Continue with comprehensive diagnostic approach below]]}}
{{Family tree | | | | | | | |!| | | |!| | |}}
{{Family tree | |,|^|v|-|v|-|-|-|.|}}
{{Family tree | | | | | | | |!| | | F01 | |F01=[[Diagnosis|Continue with comprehensive diagnostic approach below]]}}
{{Family tree | C01 |!| C02 | | C03 | |C01=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Acute heart failure|Acute heart failure]]''' </div>
{{Family tree | | | | | | | G01 | | | |G01=<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>}}
|C02=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Acute coronary syndrome|Acute coronary syndrome]]''' </div>
{{Family tree | | | | |,|-|-|-|+|-|-|-|v|-|-|-|v|-|-|-|v|-|-|.|}}
|C03=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Acute respiratory distress syndrome|Acute respiratory distress syndrome]]''' </div>}}
{{Family tree | | | | H01 | | H02 | | H03 | | H04 | | H05 | | H06
{{Family tree | |,|-|+|-|v|-|-|-|.|}}
|H01=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Acute heart failure|Acute heart failure]]''' </div>
{{Family tree | D01 |!| D02 | | D03 | |D01=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Anaphylaxis|Anaphylaxis]]''' </div>
|H02=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Acute coronary syndrome|Acute coronary syndrome]]''' </div>
|D02=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Aortic dissection|Aortic dissection]]''' </div>
|H03=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Acute respiratory distress syndrome|Acute respiratory distress syndrome]]''' </div>
|D03=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Cardiac tamponade|Cardiac tamponade]]''' </div>}}
|H04=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Anaphylaxis|Anaphylaxis]]''' </div>
{{Family tree | |,|-|+|-|v|-|-|-|.|}}
|H05=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Aortic dissection|Aortic dissection]]''' </div>
{{Family tree | F01 |!| F02 | | F03 | |F01=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Aspiration|Aspiration]]''' </div>
|H06=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Cardiac tamponade|Cardiac tamponade]]''' </div>}}
|F02=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Pneumothorax|Pneumothorax]]''' </div>
{{Family tree | | | | |,|-|-|-|v|-|-|-|v|-|-|-|v|-|-|-|v|-|-|-|.|}}
|F03=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Pulmonary embolism|Pulmonary embolism]]''' </div>}}
{{Family tree | | | | I01 | | I02 | | I03 | | I04 | | I05 | | I06
{{Family tree | |,|-|^|-|v|-|-|-|.|}}
|I01=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Aspiration|Aspiration]]''' </div>
{{Family tree | G01 | | G02 | | G03 | |G01=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Pneumonia|Pneumonia]]''' </div>
|I02=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Pneumothorax|Pneumothorax]]''' </div>
|G02=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[Asthma|Asthma]]''' </div>
|I03=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Pulmonary embolism|Pulmonary embolism]]''' </div>
|G03=<div style="float: left; text-align: left; width: 24em; padding:1em;"> '''[[COPD|COPD]]''' </div>}}
|I04=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Pneumonia|Pneumonia]]''' </div>
|I05=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[Asthma|Asthma]]''' </div>
|I06=<div style="float: left; text-align: left; width: 8em; padding:1em;"> '''[[COPD|COPD]]''' </div>}}
{{Family tree/end}}
{{Family tree/end}}



Revision as of 01:44, 29 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.

Common Causes

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

❑ Abnormal vital signs

❑ Fever
❑ Hypothermia
❑ Tachycardia
❑ Bradycardia
❑ Hypotension
❑ Tachypnea
❑ Hypopnea
❑ Hypoxia
❑ Altered mental status
❑ Wheezes
❑ Crackles
❑ Jugular venous distension
❑ Stridor
❑ Tracheal deviation
❑ Absent breath sounds
❑ Distant heart sounds
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
No
 
Continue with comprehensive diagnostic approach below
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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

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