CHF - Pulmonary Edema ALGO

Question 0

Mild

Answer 0

HR normal
BP normal
Breath sounds: rales, rhonchi, wheezes, SOB

Question 1

Congestive Heart Failure (CHF) Pulmonary Edema

Answer 1

BSI, Scene Safe, C spine, LOC, CAB (support if needed)
Vital Signs, Oxygen (if sats <94%)
History and Physical
12 lead EKG, IV

Question 2

Mild

Tx

Answer 2

Oxygen 100% 10-15L
Nitro 0.4mg SL - x3 as needed
(if SBP >90 w/IV or SBP > 110 without IV)

Question 3

Moderate/Severe

Answer 3

HR Tachycardia
BP Hypertensive
Breath sounds: Diffuse rales, wheezes, diminished, frothy sputum, SOB LE edema

Question 4

Moderate/Severe

Tx

Answer 4

Oxygen 100% NRB or BVM
Nitro 0.4mg SL-x3 as needed
(if BPS>90 with IV or SBP > 110 without IV)

Question 5

Moderate/Severe

Tx continued

Answer 5

Consider CPAP
Consider Lasix 40mg IV
Morphine 2-8mg IV
Wheezing - Albuterol Tx

Question 6

Cardio Shock

Answer 6

HR Tachycardia then bradycardia
BP Elevated then hypotension
Breath sounds diminished, respiratory failure, generalized edema

Question 7

Cardio Shock

Tx

Answer 7

Oxygen 100% BVM/ intubate
Consider intubation
Dopamine 2-10mcg/kg/min IV
titrate to BP effect