# Difficulty breathing



## RedAirplane (Feb 22, 2016)

A team was working a race when a 47 year old female presents with shortness of breath. She just ran the race, indicates chest tightness and arm tingles, and says she forgot her inhaler. As a team that is not directly involved, I respond for manpower, so I don't have the full history, vitals, etc. to share for you.

Typically if someone forgets their inhaler, I request ALS and they administer albuterol via nebulizer, and then release the patient. When the crew arrived, they were eager to take this course of action and not have to transport the patient. However, while they were assessing, apparently they found something that made them go "uh oh" and convinced her to go to the hospital. Via the game of telephone I learned that they suspected (1) shortness of breath not related to ashtma, (2) either over-hydration or under-hydration. 

What related to over- or under-hydration would cause shortness of breath not related to asthma? I'm not necessarily asking about the particular patient, because I don't have more details, but I'm curious as to how YOU would assess a difficulty breathing patient and what things might lead you to the conclusion that the paramedics did in the scenario.


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## Flying (Feb 22, 2016)

Classic heat emergency or underlying cardiac issue? Was low fluid volume straining cardiac output during/after the run? Hard to make a case for the state of hydration being a primary concern with little info. A history and some vitals is exactly what we need to come to any kind of conclusion.


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## Ewok Jerky (Feb 22, 2016)

Abnormal vitals, abnormal BG, peaked t-waves


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