How to Treat Shortness of Breath
By Jeremy Brywczynski, MD
A 9-1-1 call is received for a 68-year-old male with breathing problems. Upon arrival, the crew finds the patient confused but able to speak in short phrases. Initial vital signs are: BP 148/89, pulse 110 sinus rhythm, respiratory rate 28 and labored, O2 saturation 84% on room air and a fingerstick glucose of 145. The patient’s oxygenation and work of breathing improve markedly with 100% O2 by non-rebreather face mask. Physical examination is remarkable for increased work of breathing with rhonchi found bilaterally at the lung bases (worse on the left). No wheezing is present.
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