Management Of Acute HF

Question 1

Step 2

Answer 1

Give 100% oxygen unless there is a pre-existing lung condition

Question 2

Step 3

Answer 2

Get IV access, monitor with an ECG and treat any arrythmias

Question 3

Step 4

Answer 3

Do investigations while continuing treatment(your looking for PO). I.e. Erect CXR effusion of costophrenic angles and shadowing, U+E, troponin, ECG, ABGs

Question 4

Step 5

Answer 4

Give IV diamorphine 1.25-5.0mg slowly (caution with COPD and liver failure patients)

Question 5

Step 6

Answer 5

Furosemide 40-80mg IV and more if renal failure

Question 6

Step 7

Answer 6

Give GTN times 2 spray (don’t give if syst BP is less than 90)

Question 7

Step 8

Answer 7

Any other investigations, examination and history

Question 8

Step 9

Answer 8

If systolic BP above 100 you should start nitrate infusion

Question 9

If patient continues to deteriorate?

Answer 9

Second dose of furosemide, increase nitrate infusion as long as syst BP above 100, give CPAP ventilator

Question 10

If systolic BP falls below 100 what do you do?

Answer 10

Transfer to ICU as a cardiogenic shock patient

Question 11

What is the first thing to do?

Answer 11

Sit the patient upright