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Introduction
  • ACPO is usually as a consequence of left sided heart failure. In the acutely decompensated state the hydrostatic flow of fluid from the capillaries to the lung parenchyma is favoured causing oedema. This impairs gas exchange resulting in severe respiratory symptoms.

Read the complete article; Acute Cardiogenic Pulmonary Oedema (ACPO) in the Medical Library > Pathophysiology.

Clinical Presentation
  • Shortness of breath
  • Orthopnoea
  • Cyanosis
  • Pink frothy sputum
  • Diaphoresis
  • Crackles
  • Wheeze
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Do not suction endotracheal tube
  • Hypoxic aggression / irritability
  • Carefully titrate fluid to effect
  • Ensure oxygen is administered, even if the patient is trying to reject it (rejection may be due to hypoxia)
Management
Primary Care
Intermediate Care (EMT / Level 2)
  • Administer GTN (provided GTN is not contraindicated)
  • Apply cardiac monitor if trained and authorised
  • If IV inserted by a doctor or Paramedic, set flow rate at 20 drops per minute (TKVO)
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Clinical Deterioration
  • Dysrhythmias
  • Respiratory arrest
  • Cardiac arrest

References
References
Key Terms & Links
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