17,195
edits
Changes
no edit summary
'''Definition'''
----
According to the [[American Thoracic Society]], '''dyspnea''' is a "subjective experience of breathing discomfort that is comprised of qualitatively distinct sensations that very in intensity." Wow, that's a mouthful. Saying that definition out loud definitely can cause '''dyspnea'''. Have an inhaler ready.
'''Symptoms'''
----
Well, the main symptom for '''dyspnea''' is '''dyspnea''', sometimes shortness of breath, maybe even feeling a little winded too. Onset can be sudden or gradual, range from mild to severe, intermittent or nocturnal, and can be caused by anything from bad lungs (COPD exacerbation) to [[July Intern|bad interns]] ("You gave the patient ''how'' much insulin?!?").
'''Signs'''
----
Oxygen saturation is the most helpful of the [[Vital Signs|vital signs]]; [[Respiratory Rate|respiratory rate]], not so much, since it'll be documented as 16 breaths/min anyway. [[Physical Exam|Physical exam]] has been replaced by [[Radiology's Circle of Tests|radiology]], but should you do a [[Physical Exam|physical exam]], it is helpful to see how many lungs the patient has. [[Stethoscope|Stethoscopes]] are relics of the past, but should you find one, you can try to listen to some lung sounds. If you do so, we recommend absolutely crushing the lung exam.<ref>[http://gomerblog.com/2017/08/crushes-lung-exam-morning/ Doctor Absolutely Crushes the Lung Exam This Morning (Gomerblog)]</ref> (''For a helpful guide on the lung exam, see [http://gomerblog.com/2016/02/physical-exam-tips-the-lungs/ Gomerblog's Physical Exam Tips: The Lung].'') [[Clubbing]] is something that can only be picked up on a Friday or Saturday night. [[JVD]] may suggest the presence of JVP. Distant heart sounds suggest that you should move in a bit closer.
'''Common Causes in Health Care Professionals'''
----
#[[Pulmonary Embolism|Pulmonary embolism]] from the hours immobile of immobility spent writing notes
#The threat of litigation
#Anti-vaxxers
#Putting a foot in one's own mouth, particularly prevalent in the intern population<ref>[http://gomerblog.com/2017/07/podiatry-ent-foot-mouth/ Podiatry & ENT Take July Intern to OR to Surgically Remove Foot from Mouth (Gomerblog)]</ref>
#Taking the stairs instead of waiting for the elevator<ref>[http://gomerblog.com/2016/02/pulmonary-team-hypoxic/ Pulmonary Team Hypoxic After Climbing Seven Flights of Stairs (Gomerblog)]</ref><ref>[http://gomerblog.com/2017/05/elevator-stairs/ Nurse Waiting for Elevator Faces Stark Reality He Might Have to Take the Stairs (Gomerblog)]</ref>
----
The best treatment starts in the emergency room and involves the simultaneous initiation of any treatment that can improve shortness of breath. Therefore, when a patient presents with '''dyspnea''' initiate each of the following:
#[[Nasal Cannula|Supplemental oxygen]]
#BIPAP
#[[Endotracheal Tube|Endotracheal tube]]
#Albuterol
#Ipratropium0Ipratropium#[[Baby Aspirin|Aspirin]]#[[Statins|Statin]]#[[Morphine]]#[[Dilaudid (Hydromorphone)|Dilaudid]]
#High-dose steroids
#High-dose [[Lasix(Furosemide)|Lasix]]#[[Blood Thinner|Heparin gtt]]#[[Vancomycin]]#[[Zosyn(Piperacillin-Tazobactam)|Zosyn]]#[[Tamiflu(Oseltamivir)|Tamiflu]]#[[Micafungin]] '''Related Topics'''----* [[Allergic Ryanitis]]* [[Cough]]* [[COVID-19]]* [[Hack Up a Lung]]* [[Incentive Spirometer]]* [[Machu Picchu in Three Words: “I Can’t Breathe”]]* [[One-Trach Pony]]* [[Pneumonia]]* [[Pneumonic Device]]* [[Pulmonary Embolism]]* [[SOB]]* [[Trick Collar]]* [[Wheezy]]