Breathlessness- Core medical training

Breathlessness Core Medical Training 

© Copyright of Federation of Royal Colleges of Physicians UK Page 49 of 191 

The trainee will be able to assess a patient presenting with breathlessness to produce a valid 

differential diagnosis, investigate appropriately, formulate and implement a management plan 



 

Recall the common and/or important cardio-respiratory conditions that 

present with breathlessness 

Differentiate orthopnoea and paroxysmal nocturnal dyspnoea 

Identify non cardio-respiratory factors that can contribute to or present 

with breathlessness e.g. acidosis 

Define basic pathophysiology of breathlessness 

List the causes of wheeze and stridor 

Outline indications for CT chest (page 10), CT pulmonary angiography (pg 475), 

spirometry (page 8)

Skills 

Interpret history and clinical signs to list appropriate differential 

diagnoses: 

Differentiate between stridor and wheeze 

Order, interpret and act on initial investigations appropriately: routine 

blood tests, oxygen saturation, arterial blood gases, chest x-rays, 

ECG, Peak flow test, spirometry 

Initiate treatment in relation to diagnosis, including safe oxygen 

therapy, early antibiotics for pneumonia 

Perform chest aspiration and chest drain insertion 

Recognise disproportionate dyspnoea and hyperventilation 

Practice appropriate management of wheeze and stridor 

Evaluate and advise on good inhaler technique 

Recognise indications for ventilatory support, including intubation and 

non-invasive ventilation 

Exhibit timely assessment and treatment in the acute phase exhibit timely assessment and treatment in the acute phase 

Recognise the distress caused by breathlessness and discuss with 

patient and carers 

Recognise the impact of long term illness 

Consult senior when respiratory distress is evident 

Involve Critical Care team promptly when indicated 

 

Exhibit non-judgemental attitudes to patients with a smoking history