emDosc - December 1, 2016 - Author: Alexander D - Edited by: Koyfman A and Long B
"Summary & Take Home Points
Tachypnea can be the presentation of multiple different pathologies. A focused history and physical exam, along with an understanding of the pathophysiology of appropriate disease states, can lead to thorough evaluation and management at the bedside. A systematic organ system approach to the patient can quickly lead to bedside diagnosis and initiation of treatment in patients with undifferentiated tachypnea.
As Emergency Physicians we should:
- Avoid anchoring on the pulmonary system as the only cause of tachypnea
- Maintain a broad differential for extra-pulmonary causes of tachypnea
- Use bedside ultrasound in the setting of undifferentiated tachypnea; lung US can reveal pathology of PTX, Asthma, CHF, and PNA effectively and accurately
- Utilize follow up chest x-ray to improve diagnostic ability
- Combine EKG findings with bedside ECHO to quickly identify life threatening conditions
- Remember that metabolic acidosis can present as tachypnea & point of care testing can give clues to an early diagnosis of DKA"