Shortness of Breath

Summary: <br> You need an organized, anatomical approach.<br> <br> <br> <br> Step 1: Consider Differential Diagnosis<br> <br> <br> <br> * Upper airway* Angioedema* Foreign body* Abscess* Lower airway* COPD* Asthma* Alveoli* Pneumonia* Pulmonary edema* Blood* Anemia* Acidosis* DKA* Sepsis (lactic acid)* Toxins (salicylic acid)* Blood vessels* Pulmonary embolism* Aortic dissection* Heart* Myocardial infarction* Acute heart failure* Cardiac tamponade<br> <br> <br> <br> Step 2: Examine Anatomically<br> <br> <br> <br> * Upper airway* Stridor* Voice changes* Lower airway* Wheezing* Alveoli* Crackles* Blood* Pallor* Heart* Dysrhythmia* Jugular vein distension (JVD)* Edema<br> <br> <br> <br> Step 3: Testing Plan<br> <br> <br> <br> * Common tests* Chest x-ray* EKG* CBC* Electrolytes* Less common tests* Blood gas* Troponin* BNP* D-Dimer<br> <br> <br> <br> Step 4: Calculate Wells Score and PERC<br> <br> <br> <br> * Wells Score <a href="https://www.mdcalc.com/wells-criteria-pulmonary-embolism">(MDCalc)</a>* PERC Rule <a href="https://www.mdcalc.com/perc-rule-pulmonary-embolism">(MDCalc)</a><br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Pulmonary Embolism <a href="http://www.emclerkship.com/pulmonary-embolism/">(EM Clerkship)</a>* Shortness of Breath <a href="https://www.saem.org/cdem/education/online-education/m4-curriculum/group-m4-approach-to/shortness-of-breath">(SAEM)</a><br>