Shortness of breath
The victim is usually aware of the unusual breathing pattern. Shortness of breath can be an indicator of many physical ailments including simple exertion, a panic attack, a blow to the chest, asthma, cardiac disease, as well as exposure to toxic chemicals. If a person is suffering from shortness of breath, evaluate them for additional symptoms and possible exposures. Keep the victim in a sitting position. Remove the victim to fresh air if possible and seek medical attention.
(Charlottesville, VA) Rescue Squad (EMT) Guidelines for dealing with dyspnea:
RESPIRATORY DISTRESS / DYSPNEA
If systolic BP is greater than 90 mm Hg, keep patient in a sitting position.
Administer high FiO2, if patient has a history of lung disease use nasal cannula at 2 L/minute. If patient still is in respiratory distress slowly increase O2 and prepare to ventilate.
OBTAIN HISTORY: Onset, duration, previous episodes, chest pain, recent chest trauma, COPD, asthma, cardiac disease.
PHYSICAL EXAM: Vital signs, skin color and temperature, breath sounds, frothy or blood-tinged sputum, distended neck veins, peripheral edema.
Monitor cardiac rhythm.
RALES, FROTHY SPUTUM, DISTENDED NECK VEINS, PERIPHERAL EDEMA
Start IV D5W.
Administer Nitroglycerin 0.4 mg sublingual.
Recheck BP. If systolic BP is greater than 100 mm Hg, apply 1-2" Nitropaste.
If patient is still dyspneic after 5 minutes, give Lasix 40 mg IV.
If patient is still dyspneic and systolic BP is greater than 100 mm Hg, consider Morphine Sulfate 2-5 mg slow IV.
WHEESES, Hx COPD, ASTHMA
Administer 0.125% (3 ml/2.5 mg) Albuterol via hand held nebulizer.
Start IV D5W.
If severe asthma with no history of cardiac disease and age between 12 and 40 years of age, administer Epinephrine 1:1,000, 0.3 mg subcutaneous. (Ped. 0.01 mg/kg)
May repeat Albuterol as frequently as needed. May repeat Epinephrine in 10-20 minutes.