Emergency Medicine: Critical Signs and Symptoms by System

Respiratory: asthma exacerbation

Wheezing; shortness of breath; use of accessory muscles; tight chest; cough; tripod position

Respiratory: COPD exacerbation

Chronic cough; wheezing; barrel chest; pursed-lip breathing; increased sputum; hypoxia

Respiratory: pneumonia

Fever; productive cough; crackles; pleuritic chest pain; fatigue

Respiratory: pulmonary embolism

Sudden shortness of breath; pleuritic chest pain; tachycardia; hypoxia; history of immobility or DVT

Respiratory: pneumothorax

Sudden sharp chest pain; diminished breath sounds on one side; shortness of breath

Respiratory: tension pneumothorax (late)

JVD; tracheal deviation; absent breath sounds one side; hypotension

Respiratory: croup

Barking cough; stridor; hoarse voice; usually child under 3

Respiratory: epiglottitis

Fever; drooling; tripod position; muffled voice; stridor; do not examine the throat or agitate the patient

Cardiovascular: MI

Chest pressure; pain radiating to arm/jaw; shortness of breath; nausea; sweating; anxiety

Cardiovascular: atypical MI presentation

Women/elderly/diabetics may have fatigue; nausea; or dyspnea without classic chest pain

Cardiovascular: left heart failure

Pulmonary edema; crackles; shortness of breath; orthopnea; pink frothy sputum

Cardiovascular: right heart failure

JVD; peripheral edema; ascites; weight gain

Cardiovascular: aortic dissection/AAA

Sudden tearing chest/back/abdominal pain; unequal BP between arms; pulsatile abdominal mass; shock

Cardiovascular: hypovolemic shock

Tachycardia; pale cool clammy skin; weak pulse; anxiety; low BP (late)

Cardiovascular: cardiogenic shock

Hypotension; tachycardia; pulmonary edema; cool clammy skin; chest pain

Cardiovascular: neurogenic shock

Hypotension with bradycardia; warm dry skin below the injury; spinal cord injury

Cardiovascular: hypertensive emergency

Severe headache; BP above 180/120; blurred vision; confusion; chest pain

Neurological: stroke

Facial droop; arm weakness; slurred speech; sudden vision or balance changes; severe headache

Neurological: TIA

Stroke symptoms that resolve within minutes to hours

Neurological: seizure

Tonic-clonic movements; loss of consciousness; incontinence; tongue biting

Neurological: postictal state

Confusion; drowsiness; headache after a seizure; gradually improves

Neurological: increased intracranial pressure (Cushing's triad)

High BP; slow heart rate; irregular breathing

Neurological: head injury

Altered mental status; unequal pupils; vomiting; headache; clear fluid from ears or nose

Endocrine: hypoglycemia

Rapid onset; cold clammy skin; confusion; shakiness; tachycardia; weakness; seizure

Endocrine: hyperglycemia/DKA

Slow onset; warm dry skin; fruity breath; deep fast breathing (Kussmaul); thirst; frequent urination; nausea

Gastrointestinal: appendicitis

Pain starting near the navel then moving to the right lower quadrant; fever; nausea; loss of appetite

Gastrointestinal: GI bleed

Black tarry stool (melena); vomiting blood or coffee-ground emesis; weakness; signs of shock

Gastrointestinal: bowel obstruction

Distended abdomen; vomiting; cramping pain; no bowel movement or gas

Genitourinary: kidney stones

Severe flank pain radiating to groin; blood in urine; nausea; restlessness

Genitourinary: UTI

Burning on urination; frequency; urgency; lower abdominal pain; confusion in elderly

Musculoskeletal: fracture

Pain; deformity; swelling; bruising; loss of function; crepitus

Musculoskeletal: compartment syndrome

Severe pain out of proportion; tight swollen limb; pain on stretching; late loss of pulse

Allergic: anaphylaxis

Hives; swelling of face or tongue; wheezing; stridor; hypotension; tachycardia; vomiting

Environmental: heat exhaustion

Heavy sweating; weakness; nausea; headache; normal to mildly high temp; cool clammy skin

Environmental: heat stroke

Hot skin; temperature above 104 F; altered mental status; seizures; life-threatening

Environmental: hypothermia

Shivering (early); confusion; slow pulse and breathing; cold skin; loss of shivering (late)

Obstetric: preeclampsia

Pregnancy with high BP; headache; swelling; vision changes; upper abdominal pain

Obstetric: eclampsia

Preeclampsia signs plus seizures

Behavioral: panic attack

Rapid breathing; chest tightness; tingling; dizziness; sense of doom; rule out medical causes first

Poisoning: carbon monoxide

Headache; dizziness; nausea; confusion; cherry-red skin (late); SpO2 may read falsely normal