Out-of-hospital pulmonary edema: Diagnosis and treatment

P Rehospital U Se of C Ontinuous P Ositive a Irway P Ressure (Cpap) for P Resumed P Ulmonary E Dema : A P Reliminary C Ase S Eries

“…Previous studies have found that paramedics are correct in their diagnosis of cardiogenic pulmonary edema only 70% to 89% of the time. 1,20,21 Emergency physicians have an equally hard time making this diagnosis on entirely clinical grounds. 22 In our study there may also have been individual cases where the paramedics instituted CPAP therapy even though they were uncertain whether the primary etiology of respiratory failure was cardiogenic.…”

“…1 While prehospital therapy with oxygen, nitrates, morphine, and furosemide is often effective, patients with progressive respiratory failure generally require ventilatory support. Administering continuous positive airway pressure (CPAP) by face mask has been shown to reduce the need for endotracheal intubation (ETI) and mechanical ventilation in hospitalized patients with severe cardiogenic pulmonary edema.…”

Do Medications Affect Vital Signs in the Prehospital Treatment of Acute Decompensated Heart Failure?

“…2,5 Hospitalization of patients with acute pulmonary edema transported by ambulance is associated with a 10-15% rate of short-term mortality, as well as significant rates of acute myocardial infarction (15%) and the need for mechanical ventilation (15%). 6,7 The overall cost for all treatments of heart failure exceeded $38 billion in 1991. 8,9 Optimizing the prehospital treatment of these patients may have a beneficial effect on these outcomes.…”

PATCH4 the Flowing DAM

“…Previous studies have found paramedics to be between 70% and 88% accurate in the diagnosis of ACPE. [6][7][8] It is unclear to us whether the one patient who ''had asthma rather than CHF'' was withdrawn from the study at the outset or only in retrospect, when the alternative diagnosis was made. In the latter case, the patient should have been included in the analysis.…”