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APPROACH TO DYSPNEA, RED FLAGS, RED FLAGS, Pneumothorax: Sudden sharp…
APPROACH TO DYSPNEA
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DIFFERENTIALS
RED FLAGS PRESENT?
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INVESTIGATIONS
PULSE OXIMETRY. SaO2
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N or LOW
Epiglottidis
FB Aspiration
Bronchiolitis
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Hyperinflation, Atelectasis
Visualized FB, air trapping, hyperventilation
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RED FLAGS
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Chest pain, especially if radiating to arm, neck or jaw
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Pneumothorax: Sudden sharp chest pain, unilateral breath sounds, hyperresonance and rapid deterioration if tension pneumothorax develops, history of trauma or COPD
Acute Myocardial Infarction: Severe crushing or pressure like chest pain radiating to arm, neck or jaw. Associated with diaphoresis, nausea, palpitations
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ECG
MI, CHF, RBBB in case of Pulmonary Embolism, LVH
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OTHER CAUSES
Asthma : Presence of cough, chest tightness and wheezing, often a hisory of reactive airway disease
COPD: History of tobacco use, frequent lung infections
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Pulmonary Embolism: Sudden onset of dyspnea, pleuritic chest pain, hemoptysis, tachycardia, hypoxia,and possibly calf pain or swelling (DVT), or other hypercoagulable states.
Acute Asthma Exacerbation: Wheezing, chest tightness,use of accessory muscles and hypoxia unresponsive to initial treatment
Acute Heart Failure: (Pulmonary edema) Orthopnea, pink frothy sputum, crackles on lung auscultation, elevated JVP and peripheral edema
Anaphylaxis:Rapid onset, stridor, swelling especially of face or throat, utricaria, hypotension
Severe Pneumonia/Sepsis: Productive cough, with purulent or blood stained sputum, fever, tachycardia, hypoxia, hypotension, altered mental status
Foreign Body Aspiration: Sudden onset of coughing, chocking, stridorand wheezing especially in children.
REFERENCES:
- www.aafp.org
- Medscape
- msdmanuals
DATA GATHERED BY:
- Dr. Zenab Mumtaz
- Dr. Sadaf Maqsood
- Dr. Summaiya Salman
COMPILATION BY