The reason I say this is the word "wheeze" is too subjective, and prone to lead to questionable breathing treatments or bronchodilator abuse. Bronchodilator abuse is when bronchodilator breathing treatments are ordered for patients not having bronchospasm.
The following is a list of noises that are not true wheezes:
- cardiac wheeze
- upper airway wheeze
Likewise, there are other disease processes that can cause a wheeze, such as a pulmonary embolism, cardiac asthma (CHF) and lung cancer.
Therefore, due to the fact the word "wheeze" is too open to subjective opinion, I hereby petition it be removed from as an indicator for a bronchodilator order.
In place of wheeze I would like to see the word, "diminished lung sounds." I say this because if you listen to a patient and he has good air movement, you can be pretty assured he is not having bronchospasm -- even if you think you hear a wheeze.
Perhaps this might result in true bronchodilator reform.