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!

Avsnitt(1145)

Episode 897: Adrenal Crisis

Episode 897: Adrenal Crisis

Contributor: Ricky Dhaliwal MD Educational Pearls: Primary adrenal insufficiency (most common risk factor for adrenal crises) An autoimmune condition commonly known as Addison's Disease Defects...

1 Apr 20244min

Podcast 896: Cancer-Related Emergencies

Podcast 896: Cancer-Related Emergencies

Contributor: Travis Barlock, MD Educational Pearls: Cancer-related emergencies can be sorted into a few buckets: Infection Cancer itself and the treatments (chemotherapy/radiation) can be immunos...

25 Mars 20242min

Episode 895: Indications for Exogenous Albumin

Episode 895: Indications for Exogenous Albumin

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volu...

18 Mars 20242min

Episode 894: DKA and HHS

Episode 894: DKA and HHS

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More com...

11 Mars 20247min

Episode 893: Home Treatments for Button Battery Ingestion

Episode 893: Home Treatments for Button Battery Ingestion

Contributor: Aaron Lessen MD Educational Pearls: Button batteries cause alkaline corrosion and erosion of the esophagus when swallowed Children swallow button batteries, which create a medical eme...

4 Mars 20242min

Episode 892: Tourniquets

Episode 892: Tourniquets

Contributor: Ricky Dhaliwal, MD Educational Pearls: What can you do to control bleeding in a penetrating wound? Apply direct pinpoint pressure on the wound as well as proximal to the wound. Build ...

27 Feb 20245min

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Contributors: Kali Olson PharmD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode of Pharmacy Phriday, Dr. Kali Olson joins Dr. Travis Barlock and Jeffrey Olson in studio to discuss a var...

23 Feb 202443min

Episode 891: Hypothermia

Episode 891: Hypothermia

Contributor: Taylor Lynch MD Educational Pearls Hypothermia is defined as a core body temperature less than 35 degrees Celsius or less than 95 degrees Fahrenheit  Mild Hypothermia: 32-35 degrees C...

19 Feb 20244min

Populärt inom Vetenskap

p3-dystopia
svd-nyhetsartiklar
pojkmottagningen
dumma-manniskor
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-vetenskapsradion
rss-experimentet
rss-ufo-bortom-rimligt-tvivel
paranormalt-med-caroline-giertz
medicinvetarna
rss-vetenskapsradion-2
bildningspodden
halsorevolutionen
dumforklarat
vetenskapsradion
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
4health-med-anna-sparre
rss-spraket