A 50 y/o man with a history of CHF and COPD is brought in by ambulance in severe respiratory distress. He is sitting upright with a RR 30 and O2 saturation of 79% on room air. Is this a CHF or COPD exacerbation? This is a common dilemma faced in the ED. Fortunately there are likelihood ratios to help you risk stratify using a Fagan nomogram.
Note that there are 3 tables:
- All-comer Emergency Department (ED) patients1
- ED patients WITH a known history of asthma or COPD2
- Summative LRs for BNP are provided in ED patients with or without a history of asthma/COPD1
See the blue font for the likelihood ratios ≥ 3.0.
PV Card: Does Your Dyspneic Patient Have CHF?
Adapted from 1,2
Go to the ALiEM Cards site for more resources.