Differential diagnosis of respiratory distress:

Condition Vital signs Inspection Palpation percussion auscultatio

n
Asthma Tachypnea Dyspnea; Often Often Prolonged
& movement normal or normal, expiration,
Tachycardia of accessory Dec. Vocal markedly dec breath
muscles, fremitus hyper sound or
cyanosis, resonant absent,
hyperinflati wheezes &
on rales all
sweats over
Emphysema Stable; pink Barrel Dec. Vocal Hyper Dec. Lung
puffers chest; fremitus resonance sound
accessory Wheeze
muscles Dec.
move, seen resonance
in thin px.
Chronic Blue Px. Are Often Often Early rales,
bronchitis bloaters; short stocky normal normal ronchi, does
Tachycardia Possible not clear on
& cyanosis coughing
tachypnea
pneumonia Fever, Possible Increase Dullness Late rales,
tachypnea, cyanosis; vocal bronchial
tachycardia splinting off fremitus breath
sounds.
Pulmonary Tachycardia Often Usually normal normal
embolism & normal normal
Tachypnea
Pulmonary Tachycardia Elevated Often Often Early rales,
edema & right heart normal normal wheezes
Tachypnea pressure
pneumothor Tachycardia Normal lag, Absent VF; Hyperreson Absent
ax & on affected trachea ant breath
Tachypnea side shifted to sound
other side
Pleural Tachycardia Often Decrease Dullness Absent
effusion & normal, on VF; trachea breath
Tachypnea affected shifted to sound
side other side
Atelectasis Tachycardia Often Decrease Dullness Absent
normal, on VF; trachea breath
affected shifted to sound
side affected
side
Adult Tachycardia Cyanosis, Normal Normal Normal
respiratory & use initially late
distress Tachypnea accessory rales
syndrome muscles
Bronchiecta Sputum 3 layered Inc. VF; no Tympanetic Decrease
sis abundant sputum abnormality Breath
sounds
Or absent;
Rales