Difference between revisions of "Dyspnea"

From Gomerpedia
Jump to: navigation, search
 
(11 intermediate revisions by the same user not shown)
Line 11: Line 11:
 
'''Symptoms'''
 
'''Symptoms'''
 
----
 
----
−
Well, the main symptom for '''dyspnea''' is '''dyspnea''', sometimes shortness of breath.  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?!?").
+
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'''
 
'''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  [[Physical Exam|Physical exam]] has been replaced by [[Radiology's Circle of Tests|radiology]], but should you do a physical exam, it is helpful to see how many lungs the patient has.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.  (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.
+
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  [[Physical Exam|Physical exam]] has been replaced by [[Radiology's Circle of Tests|radiology]], but should you do a [[Physical Exam|physical exam]], it is helpful to see how many lungs the patient has.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.
  
  
Line 31: Line 31:
 
'''Common Causes in Health Care Professionals'''
 
'''Common Causes in Health Care Professionals'''
 
----
 
----
−
#[[Pulmonary Embolism|Pulmonary embolism]] from the hours immobile writing notes
+
#[[Pulmonary Embolism|Pulmonary embolism]] from the hours of immobility spent writing notes
 
#The threat of litigation
 
#The threat of litigation
 
#Anti-vaxxers
 
#Anti-vaxxers
Line 37: Line 37:
 
#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>
 
#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>
 
#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>
−
 
−
 
−
'''Related Topics'''
 
−
----
 
−
- [[Allergic Ryanitis]]
 
−
 
−
- [[Cough]]
 
−
 
−
- [[Incentive Spirometer]]
 
−
 
−
- [[Pneumonia]]
 
−
 
−
- [[SOB]]
 
−
 
−
- [[Wheezy]]
 
  
  
Line 59: Line 44:
 
#[[Nasal Cannula|Supplemental oxygen]]
 
#[[Nasal Cannula|Supplemental oxygen]]
 
#BIPAP
 
#BIPAP
−
#[[Endotracheal Tube|endotracheal tube]]
+
#[[Endotracheal Tube|Endotracheal tube]]
 
#Albuterol
 
#Albuterol
 
#Ipratropium
 
#Ipratropium
 
#[[Baby Aspirin|Aspirin]]
 
#[[Baby Aspirin|Aspirin]]
−
#[[Statin]]
+
#[[Statins|Statin]]
 
#[[Morphine]]
 
#[[Morphine]]
 
#[[Dilaudid (Hydromorphone)|Dilaudid]]
 
#[[Dilaudid (Hydromorphone)|Dilaudid]]
Line 70: Line 55:
 
#[[Blood Thinner|Heparin gtt]]
 
#[[Blood Thinner|Heparin gtt]]
 
#[[Vancomycin]]
 
#[[Vancomycin]]
−
#[[Zosyn (Piperacillin-Tazobactam|Zosyn]]
+
#[[Zosyn (Piperacillin-Tazobactam)|Zosyn]]
 
#[[Tamiflu (Oseltamivir)|Tamiflu]]
 
#[[Tamiflu (Oseltamivir)|Tamiflu]]
 
#[[Micafungin]]
 
#[[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]]
  
  

Latest revision as of 10:38, 20 March 2020

Any one of these things can f**k up and cause dyspnea

Dyspnea (also known as shortness of breath, difficulty in breathing, or breathing difficulty) sucks. Let us elaborate.


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 bad interns ("You gave the patient how much insulin?!?").


Signs

Oxygen saturation is the most helpful of the vital signs; respiratory rate, not so much, since it'll be documented as 16 breaths/min anyway. Physical exam has been replaced by radiology, but should you do a physical exam, it is helpful to see how many lungs the patient has. 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.[1] (For a helpful guide on the lung exam, see 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 the General Population

  1. Asthma
  2. COPD
  3. Interstitial lung disease
  4. Cardiovascular such as congestive heart failure or acute coronary syndrome
  5. Obesity or deconditioning
  6. Anemia


Common Causes in Health Care Professionals

  1. Pulmonary embolism from the hours of immobility spent writing notes
  2. The threat of litigation
  3. Anti-vaxxers
  4. Exasperation over something a new intern did[2][3]
  5. Putting a foot in one's own mouth, particularly prevalent in the intern population[4]
  6. Taking the stairs instead of waiting for the elevator[5][6]


Treatment

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:

  1. Supplemental oxygen
  2. BIPAP
  3. Endotracheal tube
  4. Albuterol
  5. Ipratropium
  6. Aspirin
  7. Statin
  8. Morphine
  9. Dilaudid
  10. High-dose steroids
  11. High-dose Lasix
  12. Heparin gtt
  13. Vancomycin
  14. Zosyn
  15. Tamiflu
  16. Micafungin


Related Topics


References

  1. ↑ Doctor Absolutely Crushes the Lung Exam This Morning (Gomerblog)
  2. ↑ July Intern Really Excited to Cause His Very First Pneumothorax (Gomerblog)
  3. ↑ Intern Put Into Timeout Cage to Think About What She Did (Gomerblog)
  4. ↑ Podiatry & ENT Take July Intern to OR to Surgically Remove Foot from Mouth (Gomerblog)
  5. ↑ Pulmonary Team Hypoxic After Climbing Seven Flights of Stairs (Gomerblog)
  6. ↑ Nurse Waiting for Elevator Faces Stark Reality He Might Have to Take the Stairs (Gomerblog)


Fun Stuff
Try a random entry.
Push me button.jpg
OR 
Share
this post with your friends


Random Gomerpedia Entries


Need More Gomer?



Retrieved from "http://gomerpedia.org/index.php?title=Dyspnea&oldid=17667"