Podcast 723: Nitro Drip in Flash Pulmonary Edema

Podcast 723: Nitro Drip in Flash Pulmonary Edema

Contributor: Alec Coston, MD

Educational Pearls:

  • Flash pulmonary edema or Sympathetic Crash Acute Pulmonary Edema (SCAPE) is a severe illness that requires aggressive treatment
  • Often in patients with heart failure and a sympathetic surge increasing heart rate, decreased diastolic filling, increased preload, and increased afterload causing pulmonary edema
  • Clinical diagnosis: acute onset diaphoresis and respiratory distress, hypoxia and tachypnea on exam
  • Bedside lung ultrasound will demonstrate B-lines, indicative of pulmonary edema
  • Treatment is nitroglycerin and BiPAP
  • Nitroglycerin drip can be started at 80 micrograms/minute, which is similar to the dose delivered by sublingual nitroglycerin

References

Stemple K, DeWitt KM, Porter BA, Sheeser M, Blohm E, Bisanzo M. High-dose nitroglycerin infusion for the management of sympathetic crashing acute pulmonary edema (SCAPE): A case series. Am J Emerg Med. 2021;44:262-266. doi:10.1016/j.ajem.2020.03.062

Agrawal N, Kumar A, Aggarwal P, Jamshed N. Sympathetic crashing acute pulmonary edema. Indian J Crit Care Med. 2016;20(12):719-723. doi:10.4103/0972-5229.195710

Wilson SS, Kwiatkowski GM, Millis SR, Purakal JD, Mahajan AP, Levy PD. Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure. Am J Emerg Med. 2017;35(1):126-131. doi:10.1016/j.ajem.2016.10.038

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!

Jaksot(1144)

Episode 958: Intranasal Fentanyl

Episode 958: Intranasal Fentanyl

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medi...

26 Touko 20251min

Episode 957: Cardiac Asthma

Episode 957: Cardiac Asthma

Contributor: Travis Barlock, MD Educational Pearls: Wheezing is classically heard in asthma and COPD, but it can be the result of a wide range of processes that cause airflow limitation Narrowed bro...

19 Touko 20253min

Episode 956: Psychedelics and Risk of Schizophrenia

Episode 956: Psychedelics and Risk of Schizophrenia

Contributor: Jorge Chalit-Hernandez, OMS3 Educational Pearls: Psychedelics are being studied for their therapeutic effects in mental illnesses, including major depressive disorder, post-traumatic str...

12 Touko 20252min

Episode 955: Cardiac Effects of COVID-19

Episode 955: Cardiac Effects of COVID-19

Contributor: Ricky Dhaliwal, MD Educational Pearls: What factors are considered in a COVID-19 infection? The viral load: Understood as the impact of SARS-CoV-2 viral particles infecting host cell tis...

5 Touko 20254min

Episode 954: Combo Rescue Inhalers - New Guidelines

Episode 954: Combo Rescue Inhalers - New Guidelines

Contributor: Aaron Lessen, MD Educational Pearls: What is a Rescue Inhaler? A rescue inhaler is a medication for people with asthma to quickly reverse the symptoms of an asthma attack.  Historical...

30 Huhti 20253min

Episode 953: Penicillin Allergies

Episode 953: Penicillin Allergies

Contributor: Geoff Hogan MD Educational Pearls: Penicillin allergies are relatively uncommon despite their frequent reports 10% of the population reports a penicillin allergy but only 5% of these...

21 Huhti 20252min

Episode 952: Heart Transplants

Episode 952: Heart Transplants

Contributor: Travis Barlock, MD Educational Pearls: Key clinical considerations when managing heart transplant patients due to their unique pathophysiology 1. Arrhythmias A transplanted heart i...

14 Huhti 20253min

Episode 951: Pediatric Febrile Seizures

Episode 951: Pediatric Febrile Seizures

Contributor: Taylor Lynch, MD Educational Pearls: Pediatric febrile seizures are defined as seizures that occur between the ages of six months to five years in the presence of a fever greater than o...

7 Huhti 20256min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
tiedekulma-podcast
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
filocast-filosofian-perusteet
rss-laakaripodi
rss-opeklubi
rss-lihavuudesta-podcast
rss-sosiopodi
sotataidon-ytimessa
mielipaivakirja
radio-antro
rss-radplus
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita