CHF/Pulmonary Edema

Question 1

Initial Considerations/Differential Diagnosis

Answer 1

• CHF exacerbation
• MI
• Asthma/COPD/Pneumonia/PE
• Pericardial Effusion/Tamponade
• Aspiration
• Non cardiogenic Pulmonary Edema

Question 2

S/S

Answer 2

• Respiratory distress
• Crackles
• JVD
• Frothy/pink sputum
• Peripheral Edema
• Diaphoresis
• Hypotension, shock
• Chest pain

Question 3

Pertinent HX

Answer 3

• HTN
• Hyperlipidemia
• Obesity
• Diabetes
• Smoker

Question 4

Initial Actions

Answer 4

• High Flow O2 & titrate to >94%
• Position of Comfort
• Nitroglycerine (ask about ED meds 1st)
• Aspirin
• Cardiac Monitoring/12 Lead ekg

Question 5

If no improvement/Continued Hypoxia/Respiratory Distress

Answer 5

• CPAP (as SBP & other factors allow)
  *Consider Midazolam 2.5mg (May repeat in 10 min for Max total of 5mg), if so, MUST obtain IV Access!!

Nitro, CPAP, & Midazolam w/ all lower BP

• Transport