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What questions will you ask as a medical emergency physician on duty in this situation? What must a medical emergency physician know about this situation? Dyspnea: What is it? What is another name or term for this? How many causes are there? At least 45 What are various examples? Alphabetical listing of causes of dyspnea: What are various examples? Dyspnea: What are the categories of causes? What causes it? What are the most common causes of dyspnea? What are the causes of shortness of breath that comes suddenly (called acute)? What are the causes of shortness of breath that has lasted for weeks or longer (called chronic)? What further questions need to be answered? How will you further assess this situation? What is the diagnosis? What is the treatment? Emergency health assessment on the spot. What questions will you ask as a medical emergency physician on duty in this situation? Questions that need to be answered. In certain situations at least 35 questions have to be answered to reach a correct diagnosis and appropriate treatment. https://www.qureshiuniversity.com/assessment.html Answer all of these questions completely. Is this a new or recurrent medical emergency issue for this patient? Do you have any other symptoms? Do any particular activities cause you to experience a shortness of breath? How long have you experienced a shortness of breath? What medications are you taking? What further questions need to be answered? Take a look at these questions: https://www.qureshiuniversity.com/assessment.html. Dyspnea: What is it? Difficult or labored respiration. Dyspnea is a medical emergency. What is another name or term for dyspnea? Shortness of breath Breathing difficulties Alphabetical listing of causes of dyspnea: What are various examples? Cardiac: Arrhythmia: Atrial fibrillation, inappropriate sinus tachycardia, sick sinus syndrome/bradycardia Cardiac: Myocardial: Cardiomyopathies, coronary ischemia Cardiac: Restrictive: Constrictive pericarditis, pericardial effusion/tamponade Cardiac: Valvular: Aortic insufficiency/stenosis, congenital heart disease, mitral valve insufficiency/stenosis Gastrointestinal: Dysmotility: Gastroesophageal reflux disease/aspiration, neoplasia Pulmonary: Alveolar: Bronchoalveolar carcinoma, chronic pneumonia Pulmonary: Interstitial: Drugs (e.g., methotrexate, amiodarone) or radiation therapy, lymphangitic spread of malignancy, passive congestion Pulmonary: Obstructive: Asthma/bronchitis/bronchiectasis, bronchiolitis obliterans, chronic obstructive pulmonary disease, intrabronchial neoplasm, tracheomalacia Pulmonary: Restrictive (extrinsic): Kyphoscoliosis, obesity, pleural disease/effusion, pneumothorax Pulmonary: Vascular: Chronic pulmonary embolism/blood clot, idiopathic pulmonary hypertension Pulmonary hypertension: High blood pressure in your lungs (pulmonary hypertension) Partial or complete collapsed lung (pneumothorax or atelectasis) Other Sarcoidosis Tuberculosis Choking Metabolic: Acidosis Neurogenic/amyotrophic lateral sclerosis Neurogenic/muscular dystrophic Neurogenic/phrenic nerve palsy Neurogenic/poliomyelitis Anemia/iron deficiency Anemia/hemolysis Deconditioning/obesity/sedentary lifestyle Pain/splinting/pleural-based malignancy Psychological/functional/anxiety/hyperventilation Psychological/functional/depression Traumatic Allergic Other Dyspnea: What are the categories of causes? Cardiac Respiratory/Pulmonary Metabolic Neurogenic Traumatic Allergic Other What are the most common causes of dyspnea? Acute decompensated heart failure (ADHF) Pneumonia Chronic obstructive respiratory disease (COPD) Bronchial asthma Pulmonary embolism Elderly chronic obstructive respiratory disease (COPD) and bronchial asthma are the most common causes of dyspnea. What are the causes of shortness of breath that comes suddenly (called acute)? 1. Anaphylaxis 2. Asthma 3. Carbon monoxide poisoning 4. Cardiac tamponade (excess fluid around the heart) 5. COPD (chronic obstructive pulmonary disease) — a blanket term for a group of diseases that block airflow from the lungs, including emphysema 6. Infective pneumonia or similar condition 7. Heart attack 8. Heart arrhythmia (heart rhythm problems) 9. Heart failure 10. Pneumonia (and other pulmonary infections) 11. Pneumothorax (collapsed lung) 12. Pulmonary embolism (a blood clot in an artery in the lung) 13. Sudden blood loss 14. Upper airway obstruction (blockage in the breathing passage) What are the causes of shortness of breath that has lasted for weeks or longer (called chronic)? 15. Asthma (lasting for weeks) — a long-term condition that affects airways in the lungs 16. COPD (chronic obstructive pulmonary disease) — a blanket term for a group of diseases that block airflow from the lungs, including emphysema 17. Deconditioning/lack of exercise (muscle deconditioning/see further details) 18. Heart dysfunction 19. Interstitial lung disease — a blanket term for a large group of conditions that scar the lungs 20. Obesity/body mass index (BMI) over 30 21. Pleural effusion (accumulation of fluid around the lungs) What other health conditions can make it hard to get enough air? Lung problems 22. Croup (especially in young children) 23. Pleurisy (inflammation of the membrane surrounding the lungs) 24. Pulmonary edema (excess fluid in the lungs) 25. Pulmonary fibrosis (a disease that happens when lung tissue becomes damaged and scarred) 26. Pulmonary hypertension 27. Sarcoidosis 28. Tuberculosis 29. Lung cancer Heart problems 30. Cardiomyopathy (problem with the heart muscle) 31. Heart failure 32. Pericarditis (inflammation of the tissue around the heart) Other problems 33. Anemia (a condition in which the body does not get oxygen due to a lack of healthy red blood cells) 34. Anxiety disorders 35. Broken ribs or injuries that make breathing difficult 36. Choking 37. Epiglottitis (swelling of the "lid" of the windpipe) 38. Foreign object inhaled 39. Guillain-Barre syndrome 40. Kyphoscoliosis (a chest wall deformity) 41. Myasthenia gravis (a condition causing muscle weakness) 42. Medications such as statins (cholesterol-lowering drugs) and beta-blockers (used to treat high blood pressure) 43. Extreme temperatures (being very hot or very cold). 44. Sleep apnea, which can cause paroxysmal nocturnal dyspnea (PND) 45. Research can reveal many more problems. What is the treatment? Fix the underlying cause. Here are further guidelines. What are the potential complications of shortness of breath? It is vital to seek prompt treatment if you experience shortness of breath as it can be a sign of a serious disease and, left untreated, may put you at risk of serious complications and even permanent damage. Once your doctor has diagnosed the underlying cause, you should make every effort to follow the recommended treatment plan precisely in order to minimize risk of potential complications including: * Brain damage * Heart failure * Respiratory failure * Spread of cancer * Spread of infection https://www.qureshiuniversity.com/medicaldoctor-2.html https://www.qureshiuniversity.com/icd-by-systems.html https://www.qureshiuniversity.com/medicalconditions.html |
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Not everyone with asthma takes the same medicine. Some medicines can be inhaled, or breathed in, and some can be taken as a pill. Asthma medicines come in two types—quick relief and long-term control.
Emergency treatment
Effect on daily activities / None / Well controlled
Mild Moderate Severe: Pulse/minute:> 120 Respiratory rate: Often > 30/minute Subset: Respiratory Arrest Imminent / Drowsy or confused / Paradoxical thoracoabdominal movement / Absence of wheeze / Pulse/minute: Bradycardia What is the treatment? Quick-relief medicines include: Albuterol (ProAir HFA, Proventil-HFA, Ventolin HFA, others). Levalbuterol (Xopenex, Xopenex HFA). If you go to the emergency room for an asthma attack in progress, you'll likely get a number of treatments to restore regular breathing. Treatments may include: Oxygen. Oxygen may be given through a tube attached to the nose if there are signs of too little oxygen in the blood. Quick-relief medicines. Inhaled quick-relief medicines, such as albuterol and levalbuterol, are given either with an inhaler or a nebulizer to open airways. Ipratropium (Atrovent HFA). Ipratropium is a drug also used to open airways that is inhaled with an inhaler or a nebulizer. Corticosteroids. Corticosteroids are given as a pill or shot to treat inflammation. Mechanical ventilation. If an asthma attack is life-threatening, a machine may be used to help you breathe and get extra oxygen. This may be done with a breathing mask. But in some cases, a tube is placed down the throat and into the windpipe. This procedure is called intubation. Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include: Inhaled corticosteroids. These medications include fluticasone propionate (Flovent HFA, Flovent Diskus, Xhance), budesonide (Pulmicort Flexhaler, Pulmicort Respules, Rhinocort), ciclesonide (Alvesco), beclomethasone (Qvar Redihaler), mometasone (Asmanex HFA, Asmanex Twisthaler) and fluticasone furoate (Arnuity Ellipta). You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids have a relatively low risk of serious side effects. Leukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms. Montelukast has been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away if you experience any of these reactions. Combination inhalers. These medications — such as fluticasone-salmeterol (Advair HFA, Airduo Digihaler, others), budesonide-formoterol (Symbicort), formoterol-mometasone (Dulera) and fluticasone furoate-vilanterol (Breo Ellipta) — contain a long-acting beta agonist along with a corticosteroid. Theophylline. Theophylline (Theo-24, Elixophyllin, Theochron) is a daily pill that helps keep the airways open by relaxing the muscles around the airways. It's not used as often as other asthma medications and requires regular blood tests. |
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A medical emergency physician should always ask these questions. What medicines are available in the medical emergency room? What medicines are available on the crash cart? What medicines are available for this medical condition? What medical emergency equipment is available on the crash cart? Who must provide further funding to enhance this research? |