Respiratory Distress

Respiratory Distress is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

Respiratory distress, shortness of breath, or dyspnea is a common complaint for patients presenting to the ED.

Etiology

  • Upper airway obstruction:
    • Epiglottitis
    • Croup syndromes
    • Laryngotracheobronchitis
    • Foreign body
    • Angioedema
    • Retropharyngeal abscess
  • Cardiovascular:
    • Pulmonary edema/CHF
    • Dysrhythmias
    • Cardiac ischemia
    • Pulmonary embolus
    • Pericarditis
    • Tamponade
    • Air embolism
  • Pulmonary:
    • Asthma
    • Chronic obstructive pulmonary disease (COPD)/emphysema
    • Pneumonia
    • Influenza
    • Bronchiolitis
    • Aspiration
    • Adult respiratory distress syndrome (ARDS)
    • Pulmonary edema
    • Pleural effusion
    • Toxic inhalation injury
  • Trauma:
    • Pneumothorax
    • Tension pneumothorax
    • Rib fractures
    • Pulmonary contusion
    • Fat embolism with long-bone fractures
  • Neuromuscular:
    • Guillain–Barré syndrome
    • Myasthenia gravis
  • Metabolic/systemic/toxic:
    • Anaphylaxis
    • Anemia
    • Acidosis
    • Hyperthyroidism
    • Sepsis
    • Septic emboli from IV drug use or infected indwelling lines
    • Salicylate intoxication
    • Drug overdose
    • Amphetamines
    • Cocaine
    • Sympathomimetic
    • Obesity
  • Psychogenic:
    • Anxiety disorder
    • Hyperventilation syndrome
  • Bioterrorist threats:
    • Anthrax
    • Pneumonic plague
    • Tularemia
    • Viral hemorrhagic fevers

Pediatric Considerations
  • Respiratory failure is the most common cause of cardiac arrest in infants.
  • Croup syndromes include:
    • Viral
    • Spasmodic
    • Bacterial
    • Congenital defects
    • Noninflammatory causes (foreign body, gastroesophageal reflux, trauma, tumors)
  • Most common cause of upper airway obstruction:
    • <6 mo: Congenital laryngomalacia
    • >6 mo: Viral croup
  • Epiglottitis:
    • Highest incidence at ages 2–4 yr
    • Abrupt onset
    • Fever
    • Respiratory distress and stridor
    • Difficulty swallowing oral secretions
    • Restlessness and anxiety


Pediatric Considerations
  • Amniotic fluid embolism during or after delivery
  • Septic embolism from septic abortion or postpartum uterine infection

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Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Respiratory Distress ID - 307113 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307113/all/Respiratory_Distress ER -