Document Detail

'F' is for failure. One patient's experiences provide a compelling lesson in cardiac care for EMS providers.
MedLine Citation:
PMID:  20218209     Owner:  NLM     Status:  MEDLINE    
There are many potential pathologies that cause a patient to have a complaint of shortness of breath and it may not always be easy to differentiate between heart failure, COPD/asthma and pneumonia. Misdiagnosis of heart failure is common and inappropriate treatment may be harmful. It has been shown that 25% of patients given furosemide developed significant electrolyte imbalances and hypotension requiring fluid boluses; adding morphine increased mortality by 22% compared to 2% with only nitroglycerin. If you have any question about the diagnosis, it would be appropriate to treat your patient with bronchodilators, nitroglycerin and NIPSV, avoiding morphine and furosemide. Remember that heart failure might be the result of an AMI, so it is important to consider aspirin as well.
Kyle David Bates
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  EMS magazine     Volume:  39     ISSN:  1946-4967     ISO Abbreviation:  EMS Mag     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-11     Completed Date:  2010-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101466002     Medline TA:  EMS Mag     Country:  United States    
Other Details:
Languages:  eng     Pagination:  35-43     Citation Subset:  H    
Town of Tonawanda Emergency Medical Unit, NY, USA.
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MeSH Terms
Diagnosis, Differential*
Dyspnea / etiology*
Emergency Medical Services / methods*
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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