SOB Flashcards
If a PT SOB had sudden onset and they have no PMH of this happening, what are two important and deadly DD to consider?
pulmonary embolism & spontaneous pneumothorax
If a pt presents with gradual onset of SOB or dyspnea, what are three likely causes not having any other information?
COPD, pneumonia, congestive heart failure
Stridor, voice change, and and drooling in a pt with SOB are concerning for what different causes and what is the most dangerous thing that could happen next?
concerning for obstruction or allergic rxn
The pt airway could close next
A patient presents to the ED with SOB, high BP, BILATERAL lower extremity swelling, and upon exam you hear rales and JVD. What is the worst case dx?
congestive heart failure
If a patient presents with severe SOB, what should you administer (or secure), what monitoring should they have, and what labs should be drawn?
O2 or establish airway of they cannot protect their own
monitor cardiac rhythm and pulse ox
get IV access and draw routine labs as well as ABG (CBC; BMP/CMP)
What two tests or imaging should be done in a pt with SOB?
ECG and CXRAY
What are 7 sx of a patient in acute respiratory distress?
SOB, tachypnea (rapid breaths), tachycardia (rapid HR), confusion, cough, chest px, blue fingers or lips
A patient presents to the ED with a traumatic chest injury. What are the three things you can do to assess ABC’s and what imaging and labs should you order?
Airway: ask them their name to assess airway
Breathing: same as above; are they coughing, wheezing
Circulation: check all pulses available
Remove all clothing
Order bedside CXR
Labs: CBC, Coagulation, type and screen for transfusion
A pt presents to the ED with a stab wound to his left ribcage, he has SOB, dyspnea, sharp pain that he reports is worse when he breaths. He is not coughing up any blood. What is the likely dx, imaging to confirm, and treatment?
Pneumothorax
CXR to see collapsed lung and air in pleural space
Chest tube or needle decompression to tx
A patient presents to the ED after a MVA and appears to have a broken rib near his right lung. He states he feels out of breath and his chest hurts, and upon exam you hear no breath sounds on his right side and the right lung is hypo-resonant to percussion. The patient’s BP has fallen since it was taken in the ambulance and his skin is cool and clammy, and he is becoming less conscious. What is the likely dx and tx?
hemothorax
chest tube to remove blood, transfusion if needed; stabilize pt
What are Deflating alveoli in lungs causing partial/complete lung collapse ?
atelectasis
A recent surgery pt is reporting dyspnea, and presents with a cough, and rapid, shallow breathing. They have not been out of their bed since their surgery 2 days ado. What is the likely dx and tx?
Atelectasis
Deep breathing exercises and bronchodilators
A patient presents with SOB that feels like they drowning when they lay down, they have coughed up a bit of frothy blood and have a fever. They state their sx only seem to be getting worse. They have a HX of CHF and ran out of their medicine a week ago. What is the likely DX, labs, and tx for this condition?
Pulmonary edema (fluid in lungs)
ECG, CXR, Coags, troponin, CBC, CMP, (and viral/covid panels to rule out infections)
TX is O2 and diuretics to help the CHF and remove fluid from body
What is the treatment for an acute COPD exacerbation in the ED?
Inhaled beta agonist - Albuterol & SAMA - ipratropium
What is the road test in Acute COPD pt and what does it indicate if the “pass”?
can the pt walk around and keep their O2 sat above 90%?
If yes, then they pass and can go home with meds (dont need to be admitted)
