bulldog217

Good morning. FNG here with a first post. Our Statewide (MA) Treatment Protocols also use a SBP of 100 mmHg as the low limit for NTG as well as Lasix. But locally, our Medical Director prefers us to use OLMC and get orders prior to giving NTG to a pt. with a SBP of less than 120 mmHg. So, although 150 sounded a bit high to me, the 100 mmHg "National Standard" may be a little less than standard. Additionally, back to Lasix, at a recent in-service for our new CPAP (Emergent's PortO2Vent) system, it was mentioned that we will probably be seeing a change or possibly outright removal of Lasix from the CHF protocols in the near future. The rational was better pt. outcomes with the use of CPAP and aggressive nitrates, as well as the limited pre-hospital benefits of Lasix (time to onset of action vs. our relatively short urban transport times) and new studies reporting rebound acute CHF in the ICU s/p ER/Pre-hospital Lasix. I have not yet had a chance to pull or read these studies so I can't speak to the details yet, but as soon as I find out more, I will pass it on. Best, John