6/29/2023 0 Comments Nocturnal dyspnea![]() ![]() See “ Acute management checklist for pneumonia.”.CT chest with IV contrast: hyperdense consolidation.Labs: leukocytosis, ↑ ESR/ CRP, ↑ procalcitonin.Remain vigilant for life-threatening causes of dyspnea. The severity of symptoms reported by the patient may not correlate with disease severity. Acute heart failure or flash pulmonary edema.Asthma exacerbation or COPD exacerbation.See also “ Rapidly reversible causes of respiratory failure.” ![]() Immediately life-threatening causes of dyspnea Neurological: decreased level of consciousness, agitation, focal neurological deficitsĪnticipate rapid clinical deterioration in patients with red flag features.Cardiac: hypotension, distant heart sounds, new murmur, pulsus paradoxus.Pulmonary: low SpO 2, cyanosis, stridor, signs of increased work of breathing.The presence of any of these red flags suggests that dyspnea is the result of a serious pathologic process. When evaluating a patient with dyspnea, always consider infection control and the need for PPE and patient isolation. Prioritize rapid identification and treatment of critical causes of dyspnea over advanced testing to obtain a definitive diagnosis. Advanced diagnostic testing based on initial findings.Basic diagnostics: initial laboratory studies, CXR, ECG, POCUS.Identify and treat the underlying cause.Initiate treatment for life-threatening reversible causes of dyspnea.Begin pulse oximetry and cardiac monitoring establish IV access.Manage respiratory failure if present, e.g., airway management, oxygen therapy if SpO 2 Perform an ABCDE survey and place the patient in a position of comfort.Assume that all dyspnea is life-threatening until proven otherwise and perform the following steps concurrently, not sequentially. ![]()
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