CHF/Pulmonary Edema Administrative Guideline Flashcards
1
Q
History
A
- Congestive heart failure
- Medications (digoxin, Lasix, Viagra /
sildenafil, Levitra / vardenafil, Cialis /
tadalafil) - Cardiac history -past myocardial
infarction
2
Q
Signs and symptoms
A
- Respiratory distress
- Crackles on lung exam
- Jugular vein distention
- Frothy/pink sputum
- Peripheral edema, diaphoresis
- Hypotension, shock
- Chest pain
3
Q
Differential
A
- CHF exacerbation
- MI
- Asthma/COPD/Pneumonia/PE
- Pericardial effusion/tamponade
- Aspiration
- Noncardiogenic pulmonary edema
4
Q
Respiratory distress with signs of
fluid overload and pulmonary edema
A
Administer oxygen and titrate to SaO 2 of ? 94%
Consider using the
ALS/BLS General AG
5
Q
What else can a medic do?
A
Administer nitroglycerin 0.4 mg SL tab
if SBP > 110 mm Hg
Repeat every 5 min to total of 3 doses, as BP allows
Administer aspirin 324 mg PO chewed
End-tidal CO 2 monitoring, cardiac monitoring
Perform 12-lead ECG
Consider chest pain/STEMI AG
6
Q
No clinical improvement;
continued hypoxia or respiratory distress?
A
CPAP: Continuous positive airway pressure ventilation as blood pressure allows
Begin with 5 cmH20, increase by 2.5cm H 2 0 increments
upto a max of 10 cm H 2 O
