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For Interns

This document provides guidelines for assessing and managing patients presenting with shortness of breath, chest pain, and hemoptysis in an emergency setting. Key actions include checking vital signs, administering oxygen, performing ECGs, and considering treatments such as nebulization and diuretics based on specific conditions. It emphasizes the importance of stabilization before further diagnostic imaging like chest X-rays.

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1997raj420
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11 views2 pages

For Interns

This document provides guidelines for assessing and managing patients presenting with shortness of breath, chest pain, and hemoptysis in an emergency setting. Key actions include checking vital signs, administering oxygen, performing ECGs, and considering treatments such as nebulization and diuretics based on specific conditions. It emphasizes the importance of stabilization before further diagnostic imaging like chest X-rays.

Uploaded by

1997raj420
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

For Interns and Housestaffs

C/O Shortness of breath

Assess general condition ( alert/consciousness/drowsy/disoriented)

Check vitals (pulse BP RR Sp02 CBG ) Sp02 < 93 connect 02 with NC sp02 <70 connect with FM
(whichever is available) Check pedal edema and JVP ( Consider an abg if spo2 <80 with RR <10
or >30 with accessory muscle use)

Take short history during assessment

BP <90/70 with or without ass chest pain in elderly age group do urgent ecg( portable if possible)

k/c/o asthma or copd with rhonchi on auscultation nebulise with duolin and budecort and Inj
Hydrocort 100/200 iv stat

ECG and trop t suggestive of MI give loading dose of anticoagulants and atorvas after taking history
about bleeding or recent surgery

pedal edema with b/l lower region creps (fine) inj Lasix 20/40 if bp >110/70 ( heart failure or CKD)

CXR PA and ECG always. After stabilization

( Consider an abg if spo2 persistently <85 with RR <10 or >30 with accessory muscle use and )

If so many pts in emergency room and pt


Chest pain stabilizes after initial MX , CXR not needed
Assess the character of pain (pleuritic/ dull aching/ compressing/ pin pricking)

Palpate for presence of local tenderness

Do an urgent ecg if compressing lt sided chest pain

Oral or inj analgesic if tenderness present ( keep in mind lung malignancy can present with rib
erosion )

Cxr pa after stabilisation

Hemoptysis

Assess vitals and ask about amount of hemoptysis(one tea cup full or not)

Inj tranexa 500 mg or 1 g iv stat , syr ascoryl C 2/3 tsf stat

Observe 1 hr and ask about last episode of hemoptysis

CXR PA after stabilization

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