2. **Rapid Breathing (Tachypnea):**(ie, greater than 25 breaths per minute), often with shallow breaths.
3. **Gasping or Wheezing:** Audible sounds like wheezing or gasping for air, often associated with asthma, COPD, or airway obstruction.
4. **Retractions:** The skin between the ribs or around the neck pulls in during inhalation, indicating that the person is working hard to breathe.
5. **Nasal Flaring:** Widening of the nostrils during breathing, especially noticeable in infants and children.
6. **Cyanosis:** Bluish tint to the lips, skin, or fingernails, indicating low oxygen levels in the blood.
7. **Grunting:** A grunting sound made during exhalation, common in infants with respiratory distress.
8. **Use of Accessory Muscles:** Noticeable use of neck, chest, and abdominal muscles to assist breathing.
9. **Chest Pain or Tightness:** Discomfort or pain in the chest, which may be related to the effort of breathing.
10. **Sweating:** Excessive sweating, often associated with the struggle to breathe.
11. **Confusion or Altered Mental Status:** Changes in consciousness, confusion, or agitation due to lack of oxygen to the brain.
12. **Fatigue:** Extreme tiredness or exhaustion, often due to the energy expended trying to breathe.
02. Brief, fragmented speech,,
•Inability to lie supine, sit bolt upright or in a tripod position. An exception is hepatopulmonary syndrome, where patients may breathe more comfortably when recumbent,
•Profound diaphoresis,which reflects extreme sympathetic stimulation associated with severe disease (eg, myocardial infarction, severe asthma flare, diastolic cardiac dysfunction).
•Audible stridor or wheezing, which can represent upper airway obstruction or severe bronchospasm.
•Dusky skin, which indicates poor perfusion or cyanosis.
•Agitation, somnolence, or other altered mental statusin the dyspneic patient suggests severe hypoxia or hypercarbia. Patients with a depressed mental status from carbon dioxide (CO2) retention may look comfortable and lackadaisical.
Optimize arterial oxygenation (Nasal Oxygen, Intubation)
Monitor with Pulse Oximetry
Oxygen saturation
Temperature.
Identify Life threatening Conditions