๊ณ ๋ น ์‘๊ธ‰์‹ค ํ˜ธํก๊ณค๋ž€ / Dyspnea in older emergency department patients

์ •์˜

๊ณ ๋ น ์‘๊ธ‰์‹ค ํ™˜์ž์˜ ํ˜ธํก๊ณค๋ž€์€ heart failure, pneumonia, COPD, pulmonary embolism ๋“ฑ์ด ๊ฒน์ณ ๋‚˜ํƒ€๋‚  ์ˆ˜ ์žˆ๋Š” ๋ณตํ•ฉ ์ฆ์ƒ๊ตฐ์ด๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

๊ณ ๋ น์—์„œ๋Š” ์—ฌ๋Ÿฌ ์›์ธ์ด ๋™์‹œ์— ๊ณ ๋ ค๋˜์–ด์•ผ ํ•˜๋ฉฐ ์ฆ์ƒ์ด ๋น„์ „ํ˜•์ ์ผ ์ˆ˜ ์žˆ๋‹ค. Fever ์—†๋Š” pneumonia, wheezing ์—†๋Š” heart failure ๊ฐ™์€ ์–‘์ƒ์ด ์ž„์ƒ์ ์œผ๋กœ ์ค‘์š”ํ•˜๋‹ค. Disposition error๋ฅผ ์ค„์ด๋Š” pathway ๊ฐœ๋ฐœ์ด ํ•ต์‹ฌ ๋ชฉํ‘œ๊ฐ€ ๋  ์ˆ˜ ์žˆ๋‹ค.

์ง„๋‹จ

BNP, lung ultrasound, chest X-ray, D-dimer์˜ ๊ณ ๋ น ํ˜ธํก๊ณค๋ž€ diagnostic performance๋ฅผ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋‹ค. HF, pneumonia, COPD, PE๋ฅผ ๊ตฌ๋ถ„ํ•˜๋Š” ์‘๊ธ‰์‹ค ๊ธฐ๋ฐ˜ ์ง„๋‹จ ์ „๋žต์ด ํ•„์š”ํ•˜๋‹ค.

์น˜๋ฃŒ

์น˜๋ฃŒ ์ž์ฒด๋ณด๋‹ค ์ดˆ๊ธฐ ๊ฐ๋ณ„, ๊ฒ€์‚ฌ ์„ ํƒ, disposition decision์˜ ์ •ํ™•๋„๋ฅผ ๋†’์ด๋Š” ๊ฒƒ์ด raw ์ž๋ฃŒ์˜ ์ดˆ์ ์ด๋‹ค.

์ถœ์ฒ˜

ESC heart failure guideline, ACEP VTE policy๊ฐ€ raw ์ž๋ฃŒ์—์„œ ์–ธ๊ธ‰๋˜์—ˆ๋‹ค.

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.