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Heart Failure in Adults Acute Pulmonary Edema Alogithm
Heart Failure in Adults Acute Pulmonary Edema Alogithm
36
Acute pulmonary
edema
37
38
39
SBP>160 and/or
HR>100
SBP 100-160
SBP<100
42
See Emergent
Management algorithm,
box #28, Assess blood
pressure, perfusion and
volume status
40
Consider IV
beta-blocker
43
41
Volume
overload?
Yes
Loop diuretic, IV
bolus, consider IV
infusion
A
No
45
Symptoms
improved?
44
Nitroglycerin SL or drip
47
46
Yes
Stabilized?
No
Out of guideline
Consider consultation:
Acute coronary syndrome
Myocarditis
Uncontrolled hypertension
Valvular insufficiency
Non-cardiac etiologies
Yes
No
52
48
51
Yes
49
ED observation
or short stay
admission?
Other causes?
No
No
Yes
50
53
54
Other IV therapies
having greater risk:
Morphine sulfate
Milrinone
Dobutamine
Consider emergent
imaging and/or
hemodynamic
monitoring
56
55
Back to algorithm
box #46,
Stabilized?
Yes
Symptom
relief?
No
58
57
No
Volume overload,
refractory to initial
therapy?
Yes
Out of guideline
Consider consultation:
Ultrafiltration
Hemodialysis
Return to main
algorithm box #6,
Initiate HF
Management