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)

Podcast 780: Pediatric Sedation Post-Intubation

Podcast 780: Pediatric Sedation Post-Intubation

Contributor: Aaron Lessen, MD Educational Pearls: Recent study looking at a pediatric emergency department to determine what percentage of patients after intubation received sedation within 10 minute...

10 Maj 20223min

Podcast 779: Pulse Pressure in Trauma

Podcast 779: Pulse Pressure in Trauma

Contributor: Aaron Lessen, MD Educational Pearls: Pulse pressure is the difference between the systolic and diastolic blood pressure, normal is about 40 A narrow pulse pressure is generally thought o...

9 Maj 20223min

Podcast 778: tPA for Frostbite Injury

Podcast 778: tPA for Frostbite Injury

Contributor: Peter Bakes, MD Educational Pearls: Mild frostbite injury usually only requires supportive care In severe frostbite injury, patients should receive an immediate angiogram, be admitted, a...

3 Maj 20223min

Podcast 777: Grass, Weed, and Ancient Rome

Podcast 777: Grass, Weed, and Ancient Rome

Contributor: Chris Holmes, MD Educational Pearls: Antiemetics were used in ancient Rome to help with sea-sickness and included toxic substances such as wine and wormwood and white hellborn The first ...

2 Maj 20225min

Mental Health Monthly #12: Management of Opioid Use Disorder with MAT (Medication-Assisted Treatment)

Mental Health Monthly #12: Management of Opioid Use Disorder with MAT (Medication-Assisted Treatment)

In this special episode of MHM, we feature Dr. Nadia Haddad, a Colorado psychiatrist, and Dr. Ricky Dhaliwal, an emergency medicine physician, as they discuss the implications of OUD in Colorado. As a...

27 Apr 202225min

Podcast 776: Single-Site Blood Cultures

Podcast 776: Single-Site Blood Cultures

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, blood cultures are drawn from two separate sites despite no data to suggest this is better than drawing blood from one site Recent stu...

26 Apr 20222min

Podcast 775: Olecranon Bursitis

Podcast 775: Olecranon Bursitis

Contributor: Aaron Lessen, MD Educational Pearls: Olecranon bursitis refers to inflammation in the bursa of the elbow and can be due to infection or trauma Recent study examined treating suspected se...

25 Apr 20223min

On the Streets #13: Pre-hospital Cardiology Concepts

On the Streets #13: Pre-hospital Cardiology Concepts

On this episode of On the Streets, our host, Jordan Ourada, talks with cardiologist, Dr. Chirag Chauhan, about all things cardiac. Highlighted topics: Wrist versus femoral access in the cath lab The ...

20 Apr 202241min

Populärt inom Vetenskap

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