Approach
- IV, O2, Monitor, VS, airway equipment to the bedside
- Sick/not-sick then ABC
Early Evaluation and Treatment
- Early evaluation: ECG, CXR, US, POC Hgb
- Supplemental O2, BiPAP, BVM, advanced airway
- Allergies?
- Early medical treatment: Aspirin, Duoneb, NTG (SL or gtt) if IV access, normotensive, no inferior MI
DDx – Systems Based
Airway
- Angioedema, anaphylaxis, Ludwig’s, PTA, RPA, epiglottitis, croup
- Look, listen, palpate neck and airway structures in every dyspneic pt
Cardio
- ACS/MI, pericardial effusion, CHF, PulmHTN/RV failure, tachydysrhythmia
Pulmonary
- PE, COPD/asthma, PTX, FB aspiration
- Blood, pus, or water: Alveolar hemorrhage, PNA, pulmonary edema, ARDS
Neurologic/Muscular
- Guillain Barre, Botulism (infant vs wound), myasthenia gravis
Hematologic
- Anemia, methemoglobinemia
Toxicologic
- CO, ASA, methemoglobinemia (Magic mouthwash, pyridium, cetacaine in teething gel), toxic alcohols causing metabolic acidosis
Metabolic
- DKA, other causes of metabolic acidosis
Infectious