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Wheezing Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
The following is an excerpt....
BASICS
Description
  • Result of turbulent airflow:
    • High-pitched sound with dominant frequency at 400 Hz:
      • Gas flowing through constricted airways analogous to a vibrating reed
    • Resonant vibration of the bronchial walls when airflow velocity reaches critical values
  • Caused by airway narrowing between 2–5 mm:
    • Wheezing is very low pitched with airway diameters of 5 mm.
    • Airways of <2 mm are unable to transmit sound because the energy is lost as friction heat.
  • Airway narrowing is caused by a combination of ≥1 of the following:
    • Constriction (as with reactive airway disease)
    • Peribronchial interstitial edema
    • Inflammation
    • Obstruction
Etiology
  • Pulmonary (small airway):
    • Asthma
    • Acute respiratory distress syndrome
    • Anaphylaxis
    • Aspiration pneumonia:
      • Wheezing occurs early in the disease due to intense bronchospasm following the event.
    • Byssinosis:
      • Occupational lung disease of textile workers exposed to cotton dust
    • Drugs:
      • Can precipitate ...

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