Dyspnea resident survival guide

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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.

 
 
 
 
 
 
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
❑ Abnormal vital signs

❑ Fever
❑ Hypothermia
❑ Tachycardia
❑ Bradycardia
❑ Hypotension
❑ Tachypnea
❑ Hypopnea
❑ Hypoxia
❑ Fever
❑ 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

Do's

Don'ts

References

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