CHF Pathophysiology
Failure of this side of the heart is primarily responsible for pulmonary edema
What is the Left Side
This is the medical term for difficulty breathing while lying flat
What is orthopnea?
This therapy should be initiated as quickly as possible in a suspected CHF patient with severe symptoms
What is CPAP/BiPAP?
These are the numerical SPO2 and ETCO2 indications for CPAP usage
What is <90% SPO2 and >50 ETCO2?
If a CHF patient's condition deteriorates and BP drops, this is the appropriate infusion dose of Norepinephrine
What is 0.1mcg/kg/min and titrate up to a MAP of >65mmHg?
This neurohormonal system causes sodium and water retention in heart failure
What is the RAAS (Renin-Angiotensin-Aldosterone System)?
This is a common lung sound associated with pulmonary edema
What are crackles (rales)?
This is the Protocol dose for Nitro for mild CHF when indicated
What is 0.4mg SL?
These are the two hemodynamic variables that are primarily reduced by Nitroglycerin
This is the SBP delineation between the two SCAPE treatment pathways
What is 200mmHg?
This is the medical term for fluid accumulation in the alveoli that impairs oxygen exchange
What is pulmonary edema?
Distention of this may indicate elevated right-sided heart pressures
What is the jugular vein?
This is the initial Protocol dose for nitroglycerin for moderate to severe CHF with an elevated BP
What is 0.8mg SL?
These are 2 medications that were historically used for field management of CHF that are no longer supported by evidence-based medicine in EMS
What is Furosemide (Lasix) and Morphine?
This is the onset of action for SL Nitroglycerine
What is 1-3 minutes?
This is the formula for cardiac output
What is HR X Stroke Volume?
This is the most important trending VS that can detect respiratory failure before any other
What is Waveform Capnography (ETCO2)?
These are the three monitoring modalities that should be routinely used in patient with a significant CHF exacerbatino
What is ECG, SPO2, and ETCO2?
These are the 5 contraindications of CPAP/BiPAP
1. Apnea or RR <8
2. Pneumothorax or Significant Chest Trauma
3. Tracheostomy
4. Vomiting
5. Upper GI Bleed
This CHF patient is most likely to have signs of jaundice due to liver congestion
This is what SCAPE stands for
What is Sympathetic Crashing Acute Pulmonary Edema?
This is suspected in a patient that presents with acute signs of CHF/pulmonary edema with accompanying chest pain/pressure
What is ACS or STEMI?
These 2 conditions are addressed in the treatment flowchart in PC Protocols for moderate to severe CHF exacerbations
What is SCAPE/FOSPE management?
These are the typical starting points for IPAP and EPAP when utilizing BiPAP on a CHF patient
What is IPAP of 10cm/H2O and EPAP of 5cm/H2O?
These are the two concerning percentages of BP drop in patients that receive Nitroglycerin