Breathlessness
Assess severity first, then use history and examination to guide the differential.
Clinical learning outcomes: Awaiting named clinical review.
What you should learn
- Recognise respiratory distress or exhaustion and seek help.
- Discuss likely causes and targeted initial investigations.
Recognise and explain
- Consider cardiac, respiratory, thromboembolic and other causes; oxygen is a treatment with an indication and target.
On your placement
Agree the activity and supervision with the clinical team. For patient-facing learning, seek permission and respect the patient’s comfort and care needs.
- Take a focused history and assess work of breathing.
- Review oxygen saturation, a chest image or ECG with a clinician.
- Discuss treatment response and when support needs escalating.
Start here
MLA: respiratory history
Take a focused respiratory history.
MLA: respiratory examination
Review respiratory examination technique and interpretation.
Current guidance
BTS oxygen guidance
Focus on choosing an oxygen target, monitoring and reassessment; discuss the patient’s risks before selecting a target.
NICE: breathlessness when pulmonary embolism is suspected
Use the suspected-PE assessment pathway when PE is a relevant possibility; it does not cover every cause of breathlessness.
Discuss
Assessing acute breathlessness
Recognise respiratory compromise and compare acute heart failure with pneumothorax without relying on age or a single measurement.
Practise
One learner performs. One checks the important steps and gives feedback. Then swap. These are St Emlyn’s practice tools, not official MLA scoring systems.
Respiratory examination paired practice
Practise a respiratory examination after discussing the patient’s stability and the agreed task.
On your next shift
Explain why a particular investigation or oxygen target was chosen.
Go deeper
Optional material. Advanced resources extend discussion; they do not define independent student practice. Check the publication date and compare clinical advice with current guidance.
RCEMLearning: breathlessness
Use the differential and clinical-assessment sections to prepare for a discussion with your supervisor.
How this relates to GMC graduate outcomes and the MLA
These are St Emlyn’s learning connections, not a claim that this page covers every national requirement.
Presentations and conditions: Breathlessness.
Clinical and professional capabilities: Assessment and clinical reasoning; Recognising limits and seeking help.
Practical skills: Respiratory examination.
St Emlyn’s interpretation of relevant GMC graduate outcomes and MLA themes; these are summary labels, not official topic codes or a complete curriculum.
Explore the student placement programme
Student practice and graduate expectations
About this resource and its review
A St Emlyn’s guide to learning Emergency Medicine during undergraduate placements. It is not an official medical-school or GMC curriculum. Your medical school’s curriculum and assessment requirements take precedence.
National foundations: GMC Outcomes for Graduates, the practical-skills supplement and the MLA content map applying from September 2026.
Framework checked: 8 October 2026. This is a source check, not clinical sign-off.
Clinical learning outcomes: awaiting named clinical review.
The four learning routes are St Emlyn’s groupings. The six interconnected MLA domains remain part of the official content map.