The document discusses the diagnostic approach to dyspnea in children. It begins by defining dyspnea as a symptom and respiratory distress as a sign. It then classifies dyspneic disorders by pathophysiology and anatomy into either flow disorders or volume disorders that are either intra-thoracic or extra-thoracic. Several examples of conditions are provided for each category. The diagnostic approach involves obtaining a history, performing a physical exam, ordering supporting exams, and treating based on the identified etiology.
The document discusses the diagnostic approach to dyspnea in children. It begins by defining dyspnea as a symptom and respiratory distress as a sign. It then classifies dyspneic disorders by pathophysiology and anatomy into either flow disorders or volume disorders that are either intra-thoracic or extra-thoracic. Several examples of conditions are provided for each category. The diagnostic approach involves obtaining a history, performing a physical exam, ordering supporting exams, and treating based on the identified etiology.
The document discusses the diagnostic approach to dyspnea in children. It begins by defining dyspnea as a symptom and respiratory distress as a sign. It then classifies dyspneic disorders by pathophysiology and anatomy into either flow disorders or volume disorders that are either intra-thoracic or extra-thoracic. Several examples of conditions are provided for each category. The diagnostic approach involves obtaining a history, performing a physical exam, ordering supporting exams, and treating based on the identified etiology.
The document discusses the diagnostic approach to dyspnea in children. It begins by defining dyspnea as a symptom and respiratory distress as a sign. It then classifies dyspneic disorders by pathophysiology and anatomy into either flow disorders or volume disorders that are either intra-thoracic or extra-thoracic. Several examples of conditions are provided for each category. The diagnostic approach involves obtaining a history, performing a physical exam, ordering supporting exams, and treating based on the identified etiology.
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Management of Cough and Dyspnea in
Children Training
Module 5
Diagnostic Approach of Dyspnea in Children
Pediatric Respirology Working Group
Dyspnea approach symptom (subjective) VS sign (objective) symptom: sensory experience (sensation), that only could be feel and judge by the patient psychologic disturbances
sign: respiratory distress, patient breath with
difficulties, involvement of additional respiratory muscle physiologic disturbances Dyspnea approach Acute VS Chronic (sudden onset) (long standing) acute: often resolves with treatment of the underlying condition chronic: usually result in progressive dysfunction, severe disability, and eventual death
Dyspnea clinical approach - 1 first step : ANAMNESIS identity: age, sex, etc dyspnea: acute, chronic, recurrent degree of dyspnea how long has been dyspneic timing of dyspnea: at rest, at activity, day or night triggers, factors make worse / better response to therapy underlying cardiopulmonary / neuromuscular disease associated symptoms: chest pain, cough, wheezing other signs & symptoms
stridor, symmetry of breath sound & on percussion; rales; sign of heart failure other holistic examination Dyspnea clinical approach - 3
further step : SUPPORTING EXAMINATION
Routine blood examination
Pulse oximetry Imaging diagnostic: CXR, ultrasound, Blood gas analysis Pulmonary function test Electrocardiography, echocardiography Rhinoscopy, laryngoscopy, bronchoscopy Dyspnea clinical approach - 4
last step : TREATMENT
based on etiology first aid: give O2, before we can identify the etiology; since most cases need it other cases, does not need O2 (see next) Dyspnea classification maybe oxygen is not needed
EXTRA Obstruction of proximal / larger
FLOW thorax airway disorders INTRA Obstruction of distal / smaller thorax airway
INTRA Lung parenchyma disorders
thorax Extra-pulmonary disorders VOLUME disorders EXTRA Lung compliance disorders thorax Respiratory center disorders
