Breathlessness Flashcards
Definition of sepsis
Infection + adverse host reaction (organ failure, SOFA >=2)
Quick assessment of organ f(x) for sepsis
Lungs: O2 sats
Heart: MAP
Liver: Bilirubin
Haem: Platelets
Kidneys: Creatinine
CNS: GCS
Differential for wheeze
Asthma
COPD
Heart failure
Anaphylaxis
Differential for stridor
Epiglottitis
Anaphylaxis
Trauma
Foreign body/tumour
Differntial for reduced air entry + clear chest
Pneumothorax
Pleural effusion
Differential for crepitations
Pneumonia
Pulmonary oedema
Bronchiectasis
Pulmonary fibrosis
Differential for SOB + clear chest
PE
DKA
Pneumocystis jirovecii pneumonia
CNS causes
Anaemia
Drugs e.g. salicylates
Hyperventilation (e.g. panic attack)
Signs and symptoms of anaphylaxis
Itching, urticaria
Angioedema
D+V
Wheeze, laryngeal obstruction
Tachycardia, hypotension (SHOCK)
Mimics of anaphylaxis
Carcinoid
Phaeochromocytoma
Systemic mastocytosis
Hereditary angioedema
Acute management of anaphylaxis
Secure airway, ?intubate, 100% O2
adrenaline IM
chlorphenamine and hydrocortisone IV
Saline IV (titrate against blood pressure)
Long-term management of anaphylaxis
Mast cell tryptase at 1-6h
Monitor 4-6h for biphasic reaction + safety net (more likely if happened before)
2-3d course of oral prednisolone TTO
Allergy clinic F/U if first episode
Adrenaline dose anaphylaxis
0.5mg (0.5ml of 1:1000) IM
Repeat every 5 min
Hydrocortisone dose anaphylaxis
200mg IV
Chlorphenamine dose anaphylaxis
10mg IV (of 1:1000)
Features of severe asthma attack
PEF 33-50% of expected
Unable to complete sentences
RR >25
Pulse >110