breathlessness

Breathlessness

ABCDE
Visual inspection (colour, mobility, work of breathing)
Observations (must include HR, BP, respiration rate, SPO2, use of accessory muscles and describe breathing)
Respiratory assessment, including:
- Chest auscultation in all 4 quadrants & percussion if reduced sounds
- JVP
- Heart sounds
- Breath sounds
- Oedema (legs, thighs, sacral and chest
Compare to baseline – significant change? NEWS 2 score and triggers?
Obtain comprehensive Hx with onset, aggravating/relieving factors

Possible causes:

Anaphylaxis	Wheeze and possible stridor , reduced SPO2
Anxiety	Panting, SOB with maintained SPO2
Asthma exacerbation	Wheeze +/- SPO2 changes
COPD exacerbation	Wheeze, crackles, reduced SPO2 (typically 88% to 92%)
Fibrosis	Chronic crackles
TB	Fever, sweats and weight loss, coarse crackles typically upper/midzone
Chest infection/pneumonia)	Crackles, temperatures, possible reduced SPO2 and possible wheeze
Heart failure/pulmonary	oedema Crackles to base(s), oedema to legs/thighs, +/- sacral oedema
Trauma	(haemo/pneumothorax) Reduced or absent breath sounds, unilateral chest expansion
Aspiration	Crackles to base(s), immediate or delayed cough with food, fluids or tablets, recurrent chest infection
Coronavirus (COVID-19)	Fever, cough, anosmia, ageusia, reduced SPO2
PE/VTE	SOB, chest pain, collapse