DYSPNOEA-APPROACH
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Inability to complete sentences in one breath implies severe breathlessness, differentials:
1. Wheezing? Differentials: asthma, COPD exacerbation, heart failure (cardiac asthma), anaphylaxis.
2. Stridor? Differentials: upper airway obstruction from foreign body or tumour, acute epiglottitis, anaphylaxis, trauma.
3. Crepitations? Differentials: heart failure, pneumonia, bronchiectasis, fibrosis.
4. Clear chest? Differentials: PE, hyperventilation, metabolic acidosis (diabetic ketoacidosis), anaemia, drugs (salicylates), shock ('air hunger'), CNS causes.
5. Pleural causes? Differentials: pneumothorax, pleural effusion.
6. Investigations: baseline obs, ABG, CXR, ECG, baseline bloods.
1. Wheezing? Differentials: asthma, COPD exacerbation, heart failure (cardiac asthma), anaphylaxis.
2. Stridor? Differentials: upper airway obstruction from foreign body or tumour, acute epiglottitis, anaphylaxis, trauma.
3. Crepitations? Differentials: heart failure, pneumonia, bronchiectasis, fibrosis.
4. Clear chest? Differentials: PE, hyperventilation, metabolic acidosis (diabetic ketoacidosis), anaemia, drugs (salicylates), shock ('air hunger'), CNS causes.
5. Pleural causes? Differentials: pneumothorax, pleural effusion.
6. Investigations: baseline obs, ABG, CXR, ECG, baseline bloods.
Reference(s)
Longmore, Murray; Wilkinson, Ian; Baldwin, Andrew; Wallin, Elizabeth. Oxford Handbook of Clinical Medicine - Mini Edition (Oxford Medical Handbooks) (p. 796). OUP Oxford. Kindle Edition.
Gale, M., Grantham, H., Morley, P. and Parr, M. (2016). Advanced Life Support Level 1: 3rd Australian Edition. Australian Resuscitation Council. American College Of Surgeons. Committee On Trauma (2012). ATLS : student course manual. Chicago, Ill.: American College Of Surgeons.
