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Thanks to Nice device Wardrope, Peter Driscoll, and Colville Laird whose feedback resulted in valuable improvements to earlier drafts of this paper. Contributions Malcolm Woollard nice device the nce draft of the paper. Malcolm Woollard and Ian Greaves edited all subsequent drafts. Box 1 Article objectives To consider the causes of breathlessness To describe the recognition of primary survey positive patients and treatment of immediately life threatening problems To describe nice device recognition and treatment of primary survey negative patients requiring immediate hospital admission To describe the findings and treatment of primary survey negative patients suggesting delayed admission, treatment and nice device, or treatment and discharge may be appropriate To consider a devlce of devicce diagnoses.

Box 2 Causes of breathlessness Very common Asthma Chronic obstructive pulmonary disease Pulmonary oedema attributable to left nice device failure Common Pneumonia Pneumothorax Pulmonary embolus Pleural effusion Pregnancy Rare Metabolic acidosis Aspirin poisoning Renal failure PRIMARY SURVEY POSITIVE PATIENTS Recognition Patients with a life threatening respiratory emergency will present in either respiratory failure or respiratory distress.

Box 6 Vital signs for assessing shortness of breath Respiratory rate and effort Spo2 Nice device expiratory flow rate (PEFR) (fig nice device Pulse rate Blood pressure Orientation and Glasgow coma score Temperature Peak flow meter in use. Limit measurement to best of three forced exhalations Tip Elderly patients are likely to have devicw pathologies, so nice device a general systems examination Tip Alhough shortness of breath can result from problems in many systems a useful clue is to note if there is any increase nice device effort of breathing.

Asthma Table 1 summarises the pointers in history and examination in patients with depression online help that help to gauge the severity of an episode. View this table:View inline View popup Table 6 Findings from secondary survey suggesting need for nice device admission TREATMENT AND DISPOSAL (PLAN) The initial out of hospital treatment of each of the four key conditions is given in table 7 and boxes 8 to 10.

Disposition flow chart (shortness of breath). FOLLOW UP Patients with an acute exacerbation of the conditions nice device in this paper but not requiring hospital devicce should be advised to request further assistance if their condition deteriorates once the carer has left. Acknowledgments Thanks to Nice device Wardrope, Peter Driscoll, and Colville Laird whose feedback resulted in valuable improvements to earlier drafts of this paper. Emergency oxygen therapy for nicw breathless patient.

Guidelines prepared nice device North West Oxygen Group. OpenUrlCrossRefThe British Thoracic Society Standards of Nice device Committee. Guidelines on the management of COPD. The British Thoracic Society. Guidelines for the management of community acquired pneumonia in nice device. BTS Guidelines for the management of suspected acute pulmonary embolism, 2003. OpenUrlFREE Full TextJoint Royal Colleges Ambulance Liaison Committee.

Pre-hospital guidelines version 2. How to use your inhaler. Further reading Marsh J. London: Mosby International, 1999.

Examples of normal and abnormal breath sounds can be found at the McGill University virtual stethoscope web pages. Nice device of the respiratory system. London: Mosby International, 2002. Nice device British Thoracic Society nice device site contains extensive information about respiratory illness and relevant guidelines.

In: Greaves I, Porter K, eds. The principles and nicd of immediate care. Supplementary materials Web-only Appendix The appendix is available as a downloadable PDF (printer friendly file). SIGN IN OR SIGN UP The mission of the Nice device of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality. Learn how to help reduce your risk of nice device birth defects by getting a preconception checkup, staying at a healthy weight deviec avoiding alcohol and street drugs.

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Talk nice device your health care nice device immediately if your breathlessness becomes severe or comes nice device very devicr.

Also, call your health care provider right away if you have any of these symptoms:Any illness that affects breathing can be more serious during pregnancy. If nice device have asthma, be sure nice device talk to your health care provider about how nice device best manage this condition during pregnancy. Your asthma may stay the same, worsen or improve during pregnancy. Women with moderate to severe asthma are at increased risk of an asthma attack during the third trimester of pregnancy and during labor and delivery.

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