Differential Diagnosis for EMS Fall with Abnormal Breathing
Single Most Likely Diagnosis
- Traumatic Brain Injury (TBI): Given the context of a fall, TBI is a highly plausible cause for abnormal breathing, as it can lead to increased intracranial pressure, brainstem injury, or direct injury to the respiratory centers in the brain.
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, impacting the diaphragm or other respiratory muscles.
- Pneumothorax or Hemothorax: Trauma from a fall can cause lung injuries leading to pneumothorax or hemothorax, both of which can severely impair breathing.
- Cardiac Contusion or Myocardial Infarction: The fall could have caused a blunt cardiac injury or triggered a myocardial infarction, both of which can lead to abnormal breathing due to decreased cardiac output and subsequent pulmonary congestion.
Do Not Miss Diagnoses
- Anaphylaxis: Although less common, anaphylaxis can cause abnormal breathing and can be triggered by various factors, including medications, allergens, or even the stress of a fall. Missing this diagnosis can be fatal.
- Pulmonary Embolism: Especially in patients with risk factors for deep vein thrombosis, a pulmonary embolism could occur and present with abnormal breathing. It's crucial not to miss this due to its high mortality rate if untreated.
- Status Epilepticus: Post-traumatic seizures can occur after a fall, and status epilepticus can present with abnormal breathing patterns, among other symptoms.
Rare Diagnoses
- Diaphragmatic Rupture: A rare but possible consequence of severe trauma, such as a fall, which can lead to breathing difficulties due to the mechanical impairment of diaphragmatic function.
- Fat Embolism Syndrome: Typically seen after long bone fractures, fat embolism syndrome can cause respiratory distress among other symptoms, and although rare, it's an important consideration in the context of significant trauma.