J306 Posted November 14, 2013 Share Posted November 14, 2013 I guess we're safe to assume that the dx is high pressure pulmonary edema. CPAP, GTN q 5, IV access and if we're pretty confident in our dx of high pressure pulmonary edema and confirm this with scattered/diffuse crackles along with the wheezes on auscultation, 40mg Lasix SIVP. I think that Ventolin/Atrovent 2.5mg/250mcg has its place in this tx plan to maximize oxygenation and ventilation. My only concern with providing a bronchodilator was not so much the irritation of the heart, but rather the possible complication of additional fluid to enter the bronchioles because we've now dilated them. Interesting, I didn't consider Ativan in my tx plan.. We don't carry S/L Ativan on car. The reason I'm cautious about the nebs is because I had a patient with the classic "cardiac wheeze" as the doctor called it, and I treated with nebs and it worsened my patient's condition, and I couldn't hear crackles before, but I sure could after the nebs. Link to comment Share on other sites More sharing options...
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