Status asthmaticus physical examination: Difference between revisions

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*[[Tachycardia|Increased heart rate]]
*[[Tachycardia|Increased heart rate]]
*[[Pulsus paradoxus]] (fall in [[Systolic blood pressure|SBP]] greater than 20-40 mmHg during inspiration)
*[[Pulsus paradoxus]] (fall in [[Systolic blood pressure|SBP]] greater than 20-40 mmHg during inspiration)
===Chest===
===Lungs===
====Inspection====
====Inspection====
*Use of accessory muscles of respiration such as [[sternocleidomastoid]], [[scalene]] and intercostal muscles, correlates with the disease severity
*Use of accessory muscles of respiration such as [[sternocleidomastoid]], [[scalene]] and intercostal muscles, correlates with the disease severity
Line 19: Line 19:
*Air entry may or may not be reduced depending on the disease severity
*Air entry may or may not be reduced depending on the disease severity
*Absence of [[wheeze]] and [[breath sounds]] secondary to severe airway obstruction may represent a silent chest which is an ominous sign of imminent [[respiratory failure]].
*Absence of [[wheeze]] and [[breath sounds]] secondary to severe airway obstruction may represent a silent chest which is an ominous sign of imminent [[respiratory failure]].
===Heart===
===Heart===
Progressive untreated airway obstruction and increased work of breathing eventually leads to worsening [[hypoxemia]], [[hypercarbia]] and increased [[air trapping]] with compromised [[stroke volume]] that results in [[bradycardia]], [[hypotension]], [[hypoventilation]] and subsequent [[cardiorespiratory arrest]].
Progressive untreated airway obstruction and increased work of breathing eventually leads to worsening [[hypoxemia]], [[hypercarbia]] and increased [[air trapping]] with compromised [[stroke volume]] that results in [[bradycardia]], [[hypotension]], [[hypoventilation]] and subsequent [[cardiorespiratory arrest]].

Latest revision as of 14:39, 13 February 2013

Status Asthmaticus Microchapters

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Overview

Pathophysiology

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Differentiating Status Asthmaticus from other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

Appearance

  • Sit upright with arms extended to support the upper chest (tripod position) that assists the use of accessory muscles of respiration

Vital Signs

Lungs

Inspection

  • Use of accessory muscles of respiration such as sternocleidomastoid, scalene and intercostal muscles, correlates with the disease severity
  • Intercostal retractions
  • Paradoxical thoraco-abdominal breathing

Auscultation

  • High-pitch prolong polyphonic expiratory wheeze
  • Bilateral crackles
  • Air entry may or may not be reduced depending on the disease severity
  • Absence of wheeze and breath sounds secondary to severe airway obstruction may represent a silent chest which is an ominous sign of imminent respiratory failure.

Heart

Progressive untreated airway obstruction and increased work of breathing eventually leads to worsening hypoxemia, hypercarbia and increased air trapping with compromised stroke volume that results in bradycardia, hypotension, hypoventilation and subsequent cardiorespiratory arrest.

Neurologic

  • Level of consciousness ranges from lethargy, agitation to even loss of consciousness or seizure, secondary to severe airway obstruction, hypoxia and carbon-di-oxide retention.
  • Unable to speak in full sentences

References

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