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Old 01-24-2013
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Question Best initial test for pulmonary edema!

What is best initial test for pulmonary edema ? Is it X-ray ??
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Old 01-24-2013
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Yup CXR is best initial step for diagnosing pulmonary edema
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Old 01-24-2013
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What is the best initial step for management of pulmonary edema ?
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Old 01-24-2013
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ABC
ist : airway
high flow o2
if sever endotracheal intubation or mechanical ventilation according to resp.distress

Last edited by salem; 01-24-2013 at 01:56 PM.
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Old 01-24-2013
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Quote:
Originally Posted by Novobiocin View Post
What is the best initial step for management of pulmonary edema ?
Oxygen then intravenous frusemide then morphine and for long term.......ace inhibitors.
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Old 01-25-2013
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What is the treatment for severe pulmonary edema refractory to medical therapy ?
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Old 01-25-2013
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As I can remember from Kaplan q-bank:
Oxygen (number 1), furosemide, morphine, nitrates.
If not enough - dobutamine.
If not enough and hypotensive - dopamine.
If not enough and not hypotensive - hydralasine.
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Old 01-25-2013
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Default Mtb 2 ck

Quote:
Originally Posted by aknz View Post
Oxygen then intravenous frusemide then morphine and for long term.......ace inhibitors.
Yes Initial therapy of PE includes- oxygen, loop diuretic, Morphine and nitrate.

But according to MTB 2 CK
The best initial therapy for acute PE is to remove a large volume of fluid from the vascular space with a loop diuretic (furosemide)

So???? Any views
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Old 01-26-2013
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no role for ace i think
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Old 01-29-2013
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I'm actually not quite clear what's the point of morphine in managing PE.
THe initial step is going to be oxygen, then furosemide and ace inhibitors. But Morphine is a pain killer. PE patients don't show any pain, AFAIK.
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Old 01-29-2013
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Quote:
Originally Posted by ali.aggarwal5 View Post
I'm actually not quite clear what's the point of morphine in managing PE.
Morphine = decease preload --> so decrease pulmonary congestion + Anxiolytic
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Old 01-29-2013
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Quote:
Originally Posted by salem View Post
no role for ace i think
ACEI decrease afterload--> so increase SV --> increase COP --> then congestion will improve
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bt the Q abt initial test so is it chest xray?
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Old 01-29-2013
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Treatment of acute pulmonary edema is LMNOP
where
L = Lasix,
M = morphine,
N = nitrates,
O = oxygen,
P = position/prop up the patients.

Quote:
Morphine increases venous capacitance, lowering left atrial pressure, and relieves anxiety, which can reduce the efficiency of ventilation.
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