Algorithm

1. The Medical Beast Page 1
ACUTE DYSPNEA
(1) (2) (3) (4) (5) (6) (7)
Clinical exam
ECG
Chest X-Ray
FBC – Blood gas
OBSTRUCTIVE:
Asthma
COPD exacerbation
Foreign body
Anaphylaxis
NON-OBSTRUCTIVE:
Pleural disease
Pulmonary embolism
ARDS
Pneumonia
Ischemic heart disease
CHF exacerbation
Cardiac tamponade
(1) Normal
(2) Obstructive (prolonged expiration): Asthma, COPD
(3) Bradypnea (Slow respiratory rate): Drug-induced respiratory depression, NON-Ketotic Diabetic coma, Increased ICP
(4) Kussmaul’s Breathing (fast and deep): Metabolic acidosis, Exercise, Anxiety
(5) Biot’s/Ataxic (irregular with long apneic periods): Drug-induced, increased ICP, medullary brain damage
(6) Cheyne-Stokes Breathing (changing rates and depths with apneic periods): Drug-induced, Cerebral brain damage, CHF, Uremia
(7) Apneustic (prolonged inspiratory pause): pontine lesion
Severe Head trauma
Cerebral hemorrhage
Brain tumor
Myasthenia crisis
Rib fracture
Drowning
Heroin/CO/cyanide
BZP/Barbiturates/Neuroleptics
Observe the pattern of respiration
If Respiratory
signs
If Cardiac Signs
If neurologic
signs
Other Signs