Medical Director - Harris County ESD11 Mobile Healthcare Assistant Medical Director - Montgomery County Hospital District EMS Conroe, Texas
Patients experiencing congestive heart failure (CHF) exacerbation with acute pulmonary edema (APE) require rapid preload and afterload reduction. Traditionally, prehospital treatment has been limited to sublingual nitroglycerin at doses that are not able to affect afterload. However, in the hospital setting high dose, bolus intravenous (IV) nitroglycerin has improved patient morbidity and mortality. In this session, Dr. Casey Patrick and Micheal Perlmutter will discuss how Montgomery County Hospital District EMS and North Memorial EMS both implemented a novel prehospital protocol to use bolus dose IV nitroglycerin for patients with APE. The safety, efficacy and impact of this prehospital approach to patients with APE will be discussed.
This session is included in the virtual live stream.
Differentiate between three, specific CHF exacerbation diagnoses: acute pulmonary edema, cardiogenic shock and chronic volume overload.
Discuss the basic pathophysiology underlying acute pulmonary edema.
Identify major persistent myths in CHF care based on current acute pulmonary edema literature.
Describe the rationale behind an innovative prehospital acute pulmonary edema protocol utilizing nitroglycerin via intravenous bolus dosing.