Respiratory emergency question

[MasterIntubator]

Maybe its just me.... but if a patient of mine presented like that, and the pt was like.... "Hey dude.... wassup.. I feel kinda sick, but I am not short of breath".... I would be thinking cardiac and circulatory issues as my next step after assessing his resp status.
I would offer additional oxygen PRN, but not to oversaturate them. After they reach 100% sats by nasal cannula, all a mask is gonna do is muffle the answers I need to hear and waste oxygen. ( of course, I am assuming that their ambient sats were like... 94% or so.... as some pts I have had before.

But... thats just me.

 

[Aidey]

A CPAP may help slightly, but you really want to ventilate these patients, not better oxygenate them.

As for a faster way to help a CHF patient, you would want to consider also giving lasix.

CPAP affects both ventilation and oxygenation. It provides positive pressure, and a higher concentration of oxygen.

Lasix is a last resort med in my system, and I've given it once that I can remember. Lasix increases mortality in patient's with lung infections, and EMS in general tends to be bad at telling lung sounds apart, and differentiating CHF from an infection.

 

[Shishkabob]

Not to mention for most urban / suburban EMS systems, Lasix won't really kick in until after you deliver them to the ER.





Maybe I'm confusing abbreviations here, but isn't RRT "Registered Respiratory Therapist"? I'm starting to think he isn't THAT kind of RRT and is another kind of RRT... WHat kind of "RRT" are you jammer?

 

[WolfmanHarris]

As for a faster way to help a CHF patient, you would want to consider also giving lasix.

Ummm... what?

I don't follow. How would lasix be better in acute pulmonary edema than increasing airway pressure via CPAP?

Given the length of time until lasix reaches therapeutic levels and the time it stays in the system, lasix was removed from the EMS tool box awhile ago.

 

[sir.shocksalot]

Ummm... what?

I don't follow. How would lasix be better in acute pulmonary edema than increasing airway pressure via CPAP?

Given the length of time until lasix reaches therapeutic levels and the time it stays in the system, lasix was removed from the EMS tool box awhile ago.

We still have lasix here in CO. I use it mostly to practice my mad juggling skills and as a trash can filler.
Does anyone else's system use NTG for CHF pt's? We use it often and I have gotten excellent results.

 

[WolfmanHarris]

We still have lasix here in CO. I use it mostly to practice my mad juggling skills and as a trash can filler.
Does anyone else's system use NTG for CHF pt's? We use it often and I have gotten excellent results.

SL NTG at 0.8 mg or 0.4 mg is our front line treatment, backed-up by CPAP.

 

[jjesusfreak01]

We still have lasix here in CO. I use it mostly to practice my mad juggling skills and as a trash can filler.
Does anyone else's system use NTG for CHF pt's? We use it often and I have gotten excellent results.

They do that in my area, though I can't speak to results. Nitro has a fairly quick half life, right, and Lasix takes a little while to get going, so why not give a kick start with nitro while you are waiting to lower the load?