Upload File

shortness of breath

1
OSCEs for Medical Finals, First Edition. Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, and Sathiji Nageshwaran. © 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd. Chapter 27 Shortness of breath Checklist P MP F Appropriate introduction Confirms patient’s name and age Explains reason for consultation Obtains consent Open question to elicit presenting complaint Allows patient to open up, listens carefully, remains silent and does not interrupt the patient Signposts: e.g. ‘Mr Gregory, thank you for telling me about this problem. I would like to ask a few more detailed questions. Is that all right?’ History of presenting complaint: • Onset (how it started, gradual/sudden) • Time (duration) • Alleviating factors • Exacerbating factors: • Exertion/exercise • Pollen/chemicals (asthma) • Orthopnoea (worse when lies flat) • Severity: • Exercise tolerance on a flat surface • Exercise tolerance when walking upstairs/up an incline • Shortness of breath (SOB) at rest • Variability: Is the SOB continuous throughout the day, intermittent or progressively worse? If intermittent, when is it worse/better? • Asks if patient is suffering from any other symptoms • Asks about any recent illnesses • Previous episodes of SOB Asks about other respiratory symptoms: • Cough • Sputum • Wheeze • Orthopnoea • Paroxysmal nocturnal dyspnoea • Chest pain → is it pleuritic, sharp, worse with inspiration? • Ankle oedema • Fevers ‘Red flags’: • Haemoptysis • Weight loss • Night sweats • Hoarseness Past medical history Family history: • Lung cancer • Atopy: • Asthma • Eczema • Hayfever • Ischaemic heart disease/myocardial infarction • Pulmonary fibrosis Drug history: • Methotrexate • Amiodarone • NSAIDs • Over-the-counter medication Allergies Social history: • Smoking • Alcohol • Illicit drug use • Occupation • Exposure to asbestos • Activities of daily living/functional assessment and impairment due to SOB Review of systems Use of non-verbal cues, e.g. good eye contact, nodding head and good body posture Systematic approach Explores and responds to ICE: • Ideas • Concerns • Expectations Shows empathy Non-verbal skills Avoids technical jargon Devises holistic management plan and addresses psychosocial issues as well as medical problems Summarises Offers to answer any questions Thanks patient

Upload: anz4191

Post on 25-Nov-2015

10 views

Category:

Documents


0 download

Report

DESCRIPTION

osce checklist

TRANSCRIPT

  • OSCEs for Medical Finals, First Edition. Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, and Sathiji Nageshwaran. 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.

    Chapter 27Shortness of breath

    Checklist P MP F

    Appropriate introduction

    Confirms patients name and age

    Explains reason for consultation

    Obtains consent

    Open question to elicit presenting complaint

    Allows patient to open up, listens carefully, remains silent and does not interrupt the patient

    Signposts: e.g. Mr Gregory, thank you for telling me about this problem. I would like to ask a few more detailed questions. Is that all right?

    History of presenting complaint:

    Onset (how it started, gradual/sudden) Time (duration) Alleviating factors Exacerbating factors:

    Exertion/exercise Pollen/chemicals (asthma) Orthopnoea (worse when lies flat)

    Severity: Exercise tolerance on a flat surface Exercise tolerance when walking upstairs/up an incline Shortness of breath (SOB) at rest

    Variability: Is the SOB continuous throughout the day, intermittent or progressively worse? If intermittent, when is it worse/better?

    Asks if patient is suffering from any other symptoms Asks about any recent illnesses Previous episodes of SOB

    Asks about other respiratory symptoms: Cough Sputum Wheeze Orthopnoea Paroxysmal nocturnal dyspnoea Chest pain is it pleuritic, sharp, worse with inspiration? Ankle oedema Fevers

    Red flags: Haemoptysis Weight loss Night sweats Hoarseness

    Checklist P MP F

    Past medical history

    Family history: Lung cancer Atopy:

    Asthma Eczema Hayfever

    Ischaemic heart disease/myocardial infarction Pulmonary fibrosis

    Drug history: Methotrexate Amiodarone NSAIDs Over-the-counter medication

    Allergies

    Social history: Smoking Alcohol Illicit drug use Occupation Exposure to asbestos Activities of daily living/functional assessment and

    impairment due to SOB

    Review of systems

    Use of non-verbal cues, e.g. good eye contact, nodding head and good body posture

    Systematic approach

    Explores and responds to ICE: Ideas Concerns Expectations

    Shows empathy

    Non-verbal skills

    Avoids technical jargon

    Devises holistic management plan and addresses psychosocial issues as well as medical problems

    Summarises

    Offers to answer any questions

    Thanks patient


O UTLINE OF P RESENTAION 2 To present a case of a 24F presenting with shortness of breath To present an approach to a patient with shortness of breath

Clinical Reasoning: A Teenager with Shortness of Breath

COUGHING AND SHORTNESS OF BREATH IN CHILDREN.docx

Approach to the patient with Shortness of Breath - Heart … GP/9.10am... · Approach to the patient with Shortness of Breath ... Dyspnoea is defined as abnormal or uncomfortable

Shortness of Breath of Breath.pdf · shortness of breath and respiratory distress. No chest pain, no fevers; ROS otherwise negative ! Pt in moderate respiratory distress on exam with

Persistent cough and shortness of breath: red flags... · 2019-06-25 · The Royal Marsden Persistent cough and shortness of breath: red flags Dr Mary O’Brien, Consultant Medical

Shortness of breath in a 51 year old woman

Web viewNasal flaring. Dyspnea: Shortness of breath or difficulty breathing. Patient may not be alert enough to complain of shortness of breath. Upper or Lower Airway Infection:

NON-CARDIAC CHEST PAIN AND SHORTNESS OF BREATH

Two Great Tests for Shortness of Breath: BNP & D-Dimer

Evaluation of shortness of breath: how to avoid …...Evaluation of shortness of breath: how to avoid pitfalls and make a timely diagnosis Gyorgy Mundruczo, MD Pulmonary and Critical

A 62 year old female with shortness of breath Joseph

Shortness of Breath UNC Emergency Medicine Medical Student Lecture Series

Shortness of Breath - Yolagroupf2.yolasite.com/resources/Shortness of Breath.pdf · 2015-09-16 · Case #1 ! 24 yo F with hx of asthma presenting with shortness of breath, wheezing,

Shortness of breath Interactive case based scenario & management discussion Shortness of breath... · Interactive case based scenario & management discussion Dr Matt Winter October

Cardio Modul Shortness of Breath

Shortness of breath let's discuss something important

A patient with altered sensorium and shortness of breath

interstitial lung disease UCSD shortness of breath

How to get over Shortness of Breath

Shortness of breath Abdullah Alsakka Em Consultant

Shortness of Breath

October 27 Shortness of Breath in the ER - CAPA - … · Overview •Different Cases of Shortness of Breath seen in the Emergency •Shortness of Breath 1. Determine the severity

SIR RFS Case Series: Chest Pain and Shortness of Breath

Shortness of Breath Benauwdheid - Enerca · Shortness of Breath Benauwdheid Dr. E.J. van Beers Van Creveldkliniek, UMC Utrecht, the Netherlands . 6th European Symposium on Rare Anaemias

Shortness of breath€¦ · Shortness of breath Ednin Hamzah CEO, Hospis Malaysia [email protected] APHN

Shortness of breath Interactive case based scenario ... Shortness of... · Shortness of breath Interactive case based scenario & management discussion Dr Matt Winter October 2014

Palliative Care: Shortness of Breath and Secretions Hong-Phuc Tran, M.D

Chest Pain and Shortness of Breath

shortness fever cough ORof breath OR sign of illness

Chest pain Shortness of breath Tachycardia / bradycardia Cardiac palpitations

Shortness of Breath Has You Blue? Here is What to Do · Shortness of Breath 2 components: Gas exchange and ventilatory pump Respiratory failure Shortness of breath In hospitalized

IQWiG-Berichte – Nr. 108 Pirfenidon · Abbildung 5: Meta-Analyse zur Dyspnoe (UCSD Shortness of Breath Questionnaire): ... UCSD SOB : University of California at San Diego Shortness-of-Breath

Progressive shortness of breath - جامعة الموصل - كلية طب الموصلmedicinemosul.uomosul.edu.iq/files/pages/page_217514… ·  · 2016-03-12Progressive shortness

FEVER COUGH SHORTNESS OF BREATH Say Something. · 2020-05-04 · FEVER COUGH SHORTNESS OF BREATH See Something.....Say Something. Protect yourself and others by reporting signs of