Shortness of Breath Protocols

There are a number of reasons why a person might experience shortness of breath. They might have an underlying condition or disease that requires a set protocol, or shortness of breath might come on suddenly and with no warning. Although shortness of breath might not always be cause for alarm, the precautionary measures set in place tend to address this symptom as serious. Shortness of breath has several different protocols, depending on suspected or known cause.

Unidentified Shortness of Breath

• One protocol for unidentified shortness of breath is to take a stress test administered by a respiratory therapist. This may include a treadmill test for a specified length of time. The respiratory therapist will take the patient's pulse and blood oxygen levels prior to starting the stress test and at the completion of testing. The purpose of undergoing a treadmill stress test is to determine if coronary artery or heart disease is present and whether further tests are necessary. These tests are usually ordered if patients complain of chronic fatigue and/or unexplained shortness of breath.

Shortness of Breath Caused by Pulmonary Edema

• Another protocol for shortness of breath addresses pulmonary edema. In addition to severe shortness of breath, a patient with pulmonary edema will experience crackling in both lungs. The first line of defense in this case is to administer nitroglycerin after vitals have been checked. A nurse will measure blood oxygen levels and possibly start an oxygen mask. Continued monitoring and repeat doses of nitroglycerin may be indicated.

Shortness of Breath Caused by Severe Asthma Attacks

• The protocol for a severe asthma attack involves assessing whether the patient is sitting or lying prone, and having him sit if possible, which will allow for a higher flow of oxygen. Next, the paramedics or hospital staff will take a history and monitor vital signs while administering a nebulizer, a device that delivers medication via steam inhalation. Reassessment will occur after the nebulizer treatment, and if shortness of breath still remains, preparation for transport to the hospital is necessary.

Shortness of Breath Caused by Panic Attacks Versus Heart Attacks

• Patients may also experience shortness of breath during a panic attack. If the person has no insight into her condition, panic attacks can often mimic and be mistaken for a heart attack. Panic attacks feel like heart attacks because of the shortness of breath paired with chest pain. The protocol in this situation is to visually observe the patient. If she is flushed and sweating, and clutching her chest in severe pain, it is likely she is having a heart attack.

  If the patient appears outwardly fine, with the exception of feeling chest pain and shortness of breath, a nurse will take blood oxygen and pulse tests along with history. Breathing slowly in and out of a paper bag is an old standby for panic attacks accompanied by hyperventilation. If there is any indication that the patient is having a heart attack, however, the technician will immediately administer anticoagulants, anti-platelet medication such as aspirin, and beta blockers, which reduce workload on the heart. Finally, blood will be drawn for testing, and an electrocardiogram will be administered.