Differential Diagnosis for EMS Fall with Abnormal Breathing
Single Most Likely Diagnosis
- Traumatic Brain Injury (TBI): This is the most likely diagnosis given the context of a fall, which can cause direct injury to the brain, leading to abnormal breathing due to increased intracranial pressure or brainstem injury affecting respiratory centers.
Other Likely Diagnoses
- Spinal Cord Injury: A fall can result in spinal cord injury, which may affect breathing if the injury is high enough in the cervical spine to impair the function of the diaphragm or other respiratory muscles.
- Pneumothorax or Hemothorax: Trauma from a fall can cause lung injury, leading to pneumothorax (air in the pleural space) or hemothorax (blood in the pleural space), both of which can cause abnormal breathing.
- Rib Fractures: Fractured ribs can cause pain that leads to shallow breathing or can directly injure the lungs or surrounding tissues, affecting breathing.
Do Not Miss Diagnoses
- Cardiac Arrest: Although less common as a direct result of a fall, cardiac arrest can occur due to the trauma or as a complication of another condition (e.g., pulmonary embolism). It is critical to identify and treat promptly.
- Pulmonary Embolism: While not directly caused by a fall, immobilization after a fall can increase the risk of deep vein thrombosis and subsequent pulmonary embolism, which can cause sudden onset of abnormal breathing.
- Anaphylaxis: If the fall was due to or complicated by an allergic reaction (e.g., to a medication or insect sting), anaphylaxis could be a life-threatening cause of abnormal breathing.
Rare Diagnoses
- Diabetic Emergency (Hypoglycemia or Hyperglycemia): Although not directly related to falls, a diabetic emergency could cause altered mental status leading to a fall and abnormal breathing.
- Meningitis or Encephalitis: Infections like meningitis or encephalitis can cause altered mental status, leading to falls and abnormal breathing patterns, though they are less directly related to the context of a fall.
- Epileptic Seizure: A seizure could cause a fall and post-ictal confusion or respiratory depression, leading to abnormal breathing.