Pulmonary Oedema (Pleural/Pulmonary Disease)

Question 1

What are the main causes of pulmonary oedema?

Answer 1

Aspiration, ARDS, pulmonary contusion, infusion associated circulatory overload, heart failure, hypertensive crisis, head injury, seizures, strangulation

Question 2

What are symptoms of pulmonary oedema?

Answer 2

SOB +/- orthopnea +/- paroxysmal nocturnal dyspnea and a productive cough with pink frothy sputum

Question 3

What are general signs of pulmonary oedema?

Answer 3

Distressed, sweaty, pale and peripheral oedema

Question 4

What are cardiovascular signs of pulmonary oedema?

Answer 4

Tachycardia, raised JVP

Question 5

What are respiratory signs of pulmonary oedema?

Answer 5

Bi-basal crepitations and wheeze

Question 6

What investigations would be done to confirm a diagnosis of pulmonary oedema?

Answer 6

Bloods (FBC, U/E, ABG, troponin, BNP) and ECG / CXR.

Question 7

What is the general management of pulmonary oedema?

Answer 7

ABCDE, sit patient upright and high flow oxygen

Question 8

What is the drug management of pulmonary oedema?

Answer 8

• Morphine (distress relief)
• IV furosemide +/- nitrates (GTN)
• Only give nitrates if systolic > 90
• If patent does not response to first or second dose of furosemide, consider mechanical ventilation