Acute Cardiogenic Pulmonary Edema Pneumonia - Revision history

Treloars at 14:32, 24 April 2020

2020-04-24T14:32:23Z

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	[[Initial Medical Assessment and Care\|INITIAL MEDICAL CARE]] (2.01) - [[~~Medical Gases~~\|OXYGEN]] @ 100% via NRB mask or assist with [[Continuous Positive Airway Pressure Device\|CPAP]] device in the patient with severe dyspnea.		[[Initial Medical Assessment and Care\|INITIAL MEDICAL CARE]] (2.01) - [[Oxygen\|OXYGEN]] @ 100% via NRB mask or assist with [[Continuous Positive Airway Pressure Device\|CPAP]] device in the patient with severe dyspnea.

Treloars at 13:05, 24 April 2020

2020-04-24T13:05:33Z

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	**'''''Nitro is contraindicated if pt states use of Viagra, Levitra or Cialis (or any ED class of drugs) in the past 24-36 hours. (Document as a pertinent negative).'''''		**'''''Nitro is contraindicated if pt states use of Viagra, Levitra or Cialis (or any ED class of drugs) in the past 24-36 hours. (Document as a pertinent negative).'''''
	* If systolic BP > 110 mm Hg, [[Nitro_Drip\|NITROGLYCERIN DRIP]] (25 mg in 500cc). Start at 5-15 mcg / minute via Infusion Regulator (“Dial a Flow” device) or Buretrol set. Increase by 5 mcg/min increments. Consider second IV of NaCl, however keep in mind the patient may be a candidate for Fibrinolytics. Monitor and document BP every 5 minutes.		* If systolic BP > 110 mm Hg, [[Nitro_Drip\|NITROGLYCERIN DRIP]] (25 mg in 500cc). Start at 5-15 mcg / minute via Infusion Regulator (“Dial a Flow” device) or Buretrol set. Increase by 5 mcg/min increments. Consider second IV of NaCl, however keep in mind the patient may be a candidate for Fibrinolytics. Monitor and document BP every 5 minutes.
	* If systolic BP > 90 mm Hg, [[~~Diuretics~~\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)		* If systolic BP > 90 mm Hg, [[Lasix\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)
	**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''		**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''
	* If systolic BP > 110mm HG and patient has not improved or the patient is anxious consider [[Morphine_Sulfate\|MORPHINE SULFATE]] (2.04) refer to [[Analgesia and Sedation\|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04).		* If systolic BP > 110mm HG and patient has not improved or the patient is anxious consider [[Morphine_Sulfate\|MORPHINE SULFATE]] (2.04) refer to [[Analgesia and Sedation\|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04).

Treloars at 12:49, 24 April 2020

2020-04-24T12:49:14Z

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	* If PULSE < 60 and systolic BP < 90 mm Hg, refer to [[Supraventricular Bradycardia and AV Blocks\|SUPRAVENTRICULAR BRADYCARDIA AND A.V. BLOCKS PRACTICE PARAMETERS]] (4.06).		* If PULSE < 60 and systolic BP < 90 mm Hg, refer to [[Supraventricular Bradycardia and AV Blocks\|SUPRAVENTRICULAR BRADYCARDIA AND A.V. BLOCKS PRACTICE PARAMETERS]] (4.06).
	* If PULSE > 60 and systolic BP < 90 mm Hg, refer to [[Shock\|SHOCK PRACTICE PARAMETER]] (5.13).		* If PULSE > 60 and systolic BP < 90 mm Hg, refer to [[Shock\|SHOCK PRACTICE PARAMETER]] (5.13).
	* If wheezing present, and pulse rate < 150 administer [[~~Bronchodilators~~\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate and repeat as necessary or until HR> 150. [[~~Bronchodilators~~\|IPRATROPIUM BROMIDE (ATROVENT)]] is contraindicated)		* If wheezing present, and pulse rate < 150 administer [[Albuterol\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate and repeat as necessary or until HR> 150. [[Atrovent\|IPRATROPIUM BROMIDE (ATROVENT)]] is contraindicated)
	* If systolic BP > 110 mm Hg, and no presence of fever or other signs of pneumonia:		* If systolic BP > 110 mm Hg, and no presence of fever or other signs of pneumonia:
	** [[Nitro_Spray\|NITROGLYCERIN SPRAY]] OR [[Nitro_Tablets\|NITROGLYCERIN TABLET]] 0.4 mg SL (Do not withhold if unable to establish IV). Repeat at 5 minute intervals until systolic BP < 110 mm Hg or [[Nitro_Drip\|NITROGLYCERIN DRIP]] established. (Team member shall be assigned as the “nitro-time keeper” and BP monitor)		** [[Nitro_Spray\|NITROGLYCERIN SPRAY]] OR [[Nitro_Tablets\|NITROGLYCERIN TABLET]] 0.4 mg SL (Do not withhold if unable to establish IV). Repeat at 5 minute intervals until systolic BP < 110 mm Hg or [[Nitro_Drip\|NITROGLYCERIN DRIP]] established. (Team member shall be assigned as the “nitro-time keeper” and BP monitor)

Treloars at 21:25, 23 April 2020

2020-04-23T21:25:50Z

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	* If wheezing present, and pulse rate < 150 administer [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate and repeat as necessary or until HR> 150. [[Bronchodilators\|IPRATROPIUM BROMIDE (ATROVENT)]] is contraindicated)		* If wheezing present, and pulse rate < 150 administer [[Bronchodilators\|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate and repeat as necessary or until HR> 150. [[Bronchodilators\|IPRATROPIUM BROMIDE (ATROVENT)]] is contraindicated)
	* If systolic BP > 110 mm Hg, and no presence of fever or other signs of pneumonia:		* If systolic BP > 110 mm Hg, and no presence of fever or other signs of pneumonia:
	** [[~~Antianginals~~\|NITROGLYCERIN]] 0.4 mg SL (Do not withhold if unable to establish IV). Repeat at 5 minute intervals until systolic BP < 110 mm Hg or [[~~Antianginals~~\|NITROGLYCERIN DRIP]] established. (Team member shall be assigned as the “nitro-time keeper” and BP monitor)		** [[Nitro_Spray\|NITROGLYCERIN SPRAY]] OR [[Nitro_Tablets\|NITROGLYCERIN TABLET]] 0.4 mg SL (Do not withhold if unable to establish IV). Repeat at 5 minute intervals until systolic BP < 110 mm Hg or [[Nitro_Drip\|NITROGLYCERIN DRIP]] established. (Team member shall be assigned as the “nitro-time keeper” and BP monitor)
	**'''''Nitro is contraindicated if pt states use of Viagra, Levitra or Cialis (or any ED class of drugs) in the past 24-36 hours. (Document as a pertinent negative).'''''		**'''''Nitro is contraindicated if pt states use of Viagra, Levitra or Cialis (or any ED class of drugs) in the past 24-36 hours. (Document as a pertinent negative).'''''
	* If systolic BP > 110 mm Hg, [[~~Antianginals~~\|NITROGLYCERIN DRIP]] (25 mg in 500cc). Start at 5-15 mcg / minute via Infusion Regulator (“Dial a Flow” device) or Buretrol set. Increase by 5 mcg/min increments. Consider second IV of NaCl, however keep in mind the patient may be a candidate for Fibrinolytics. Monitor and document BP every 5 minutes.		* If systolic BP > 110 mm Hg, [[Nitro_Drip\|NITROGLYCERIN DRIP]] (25 mg in 500cc). Start at 5-15 mcg / minute via Infusion Regulator (“Dial a Flow” device) or Buretrol set. Increase by 5 mcg/min increments. Consider second IV of NaCl, however keep in mind the patient may be a candidate for Fibrinolytics. Monitor and document BP every 5 minutes.
	* If systolic BP > 90 mm Hg, [[Diuretics\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)		* If systolic BP > 90 mm Hg, [[Diuretics\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)
	**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''		**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''

Treloars at 20:19, 22 April 2020

2020-04-22T20:19:07Z

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	* If systolic BP > 90 mm Hg, [[Diuretics\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)		* If systolic BP > 90 mm Hg, [[Diuretics\|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)
	**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''		**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''
	* If systolic BP > 110mm HG and patient has not improved or the patient is anxious consider [[~~Analgesics~~\|MORPHINE SULFATE]] (2.04) refer to [[Analgesia and Sedation\|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04).		* If systolic BP > 110mm HG and patient has not improved or the patient is anxious consider [[Morphine_Sulfate\|MORPHINE SULFATE]] (2.04) refer to [[Analgesia and Sedation\|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04).

	'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''		'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''

	[[Category:Cardiac\|0411]]		[[Category:Cardiac\|0411]]

Treloars at 15:39, 1 February 2018

2018-02-01T15:39:47Z

← Older revision		Revision as of 15:39, 1 February 2018
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	'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''		'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''

	[[Category:Cardiac]]		[[Category:Cardiac\|0411]]

Treloars: /* Section 4 - CARDIAC */

2012-04-02T00:58:09Z

Section 4 - CARDIAC

← Older revision		Revision as of 00:58, 2 April 2012
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	'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''		'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''

			[[Category:Cardiac]]

Treloars: Created page with "==Section 4 - CARDIAC== ===4.11 ACUTE CARDIOGENIC PULMONARY EDEMA=== INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% v..."

2012-02-02T15:12:25Z

Created page with "==Section 4 - CARDIAC== ===4.11 ACUTE CARDIOGENIC PULMONARY EDEMA=== INITIAL MEDICAL CARE (2.01) - OXYGEN @ 100% v..."

New page

==Section 4 - CARDIAC==
===4.11 ACUTE CARDIOGENIC PULMONARY EDEMA===

[[Initial Medical Assessment and Care|INITIAL MEDICAL CARE]] (2.01) - [[Medical Gases|OXYGEN]] @ 100% via NRB mask or assist with [[Continuous Positive Airway Pressure Device|CPAP]] device in the patient with severe dyspnea.

* If PULSE < 60 and systolic BP < 90 mm Hg, refer to [[Supraventricular Bradycardia and AV Blocks|SUPRAVENTRICULAR BRADYCARDIA AND A.V. BLOCKS PRACTICE PARAMETERS]] (4.06).
* If PULSE > 60 and systolic BP < 90 mm Hg, refer to [[Shock|SHOCK PRACTICE PARAMETER]] (5.13).
* If wheezing present, and pulse rate < 150 administer [[Bronchodilators|ALBUTEROL (PROVENTIL)]] 2.5 mg via updraft. Monitor heart rate and repeat as necessary or until HR> 150. [[Bronchodilators|IPRATROPIUM BROMIDE (ATROVENT)]] is contraindicated)
* If systolic BP > 110 mm Hg, and no presence of fever or other signs of pneumonia:
** [[Antianginals|NITROGLYCERIN]] 0.4 mg SL (Do not withhold if unable to establish IV). Repeat at 5 minute intervals until systolic BP < 110 mm Hg or [[Antianginals|NITROGLYCERIN DRIP]] established. (Team member shall be assigned as the “nitro-time keeper” and BP monitor)
**'''''Nitro is contraindicated if pt states use of Viagra, Levitra or Cialis (or any ED class of drugs) in the past 24-36 hours. (Document as a pertinent negative).'''''
* If systolic BP > 110 mm Hg, [[Antianginals|NITROGLYCERIN DRIP]] (25 mg in 500cc). Start at 5-15 mcg / minute via Infusion Regulator (“Dial a Flow” device) or Buretrol set. Increase by 5 mcg/min increments. Consider second IV of NaCl, however keep in mind the patient may be a candidate for Fibrinolytics. Monitor and document BP every 5 minutes.
* If systolic BP > 90 mm Hg, [[Diuretics|FUROSEMIDE]] 1 mg / kg Slow IVP. (Maximum dosage is 100 mg)
**'''''NOTE: Furosemide should only be used, when you are sure the patient has CHF. Do not give a diuretic to a dehydrated patient. Check for edematous legs, jugular vein distention, ascites, sacral edema & rales.'''''
* If systolic BP > 110mm HG and patient has not improved or the patient is anxious consider [[Analgesics|MORPHINE SULFATE]] (2.04) refer to [[Analgesia and Sedation|ANALGESIA/SEDATION PRACTICE PARAMETERS]] (2.04).

'''''Goal is for a B/P reduction to approximately 120/60 without an increase in pulse. This is for patients with no neurological involvement only.'''''