Shortness of Breath Flashcards
1
Q
Which patients should you consider using NIPPV for?
A
moderate to severe dyspnea accessory muscle use paradoxical abdominal movement fatigue RR over 25 pH<7.35 pCO2>45
2
Q
When shouldn’t you use NIPPV?
A
respiratory arrest/absent respiratory drive hemodynamic instability aspiration risk airway obstruction unable to tolerate mask mask does not fit AMS
3
Q
What are the key elements of the history in SOB?
A
sudden onset? chronic or recurrent? positional or exertional? precipitating events? pertinent past med history - COPD, asthms, CHF?
4
Q
What are the key physical exam elements in SOB?
A
visible airway swelling? voice changes/stridor/drooling? absent or diminished breath sounds? wheezing? Rales? JVD/peripheral edema? leg swelling/tenderness? signs of chest trauma? tripoding?
5
Q
What additional tests should you run on a patient with SOB?
A
EKG
Chest x-ray
Chest CT for atypical infections, traumas, PE or aortic pathology
Bedside US for pneumothorax, effusion or consolitation
Labs: D-dimer, BNP, troponin
6
Q
What should you have on your critical differential diagnosis for SOB?
A
acute CHF ACS anaphylaxis asthma/copd exac cardiac tamponade plmonary edema PE pneumonia pneumothorax upper airway obstruction
