Protocol 2-726 - Pulmonary Edema

CMH EMS & MIH Protocols

EMD:

• No specific protocol.

EMR:

• Oxygen to maintain SpO2 between 94-99%.
• Apply cardiac monitor limb leads.
• Elevate head of Cot.

EMT:

• Ensure completion of applicable items above.
• Assist ALS with Capnography.

• Adult:	Pediatric:
  Consider assisting ALS with CPAP.

AEMT:

• Ensure completion of applicable items above.
• Consider IV lock in AC (left is preferred) with pigtail extension with 18 ga or greater.
• Consider Albuterol 2.5 mg in NS 3 ml Nebulized.
• Wheezing or obstructed EtCO2 waveform: Refer to Protocol 2-770 - Respiratory Distress, however, do NOT administer Epinephrine.

RN:

• Ensure completion of all applicable items above.
• Consider Ventilator in CPAP mode with PSV (BiPAP).
• Consider IO lock.
• Obtain 12-Lead ECG. Consider 15-Lead ECG.

• Adult:	Pediatric:
  SBP less than 110: Consider Captopril 12.5 mg SL. Consider Dopamine 5-10 mcg/kg/min IV/IO. Click "calculate" to get dose. Consider Nitroglycerine 60+ mcg/min IV/IO. Titrate to SBP greater than 90 and dyspnea. SBP greater than 110: Consider Captopril 25 mg SL. Consider Nitroglycerine 0.4-0.8 mg SL every 3-5 minutes until no dyspnea or SBP less than 90.	Consider contacting MEDICAL CONTROL.

Medic:

• Ensure completion of all applicable items above.
• Consider Protocol 2-044 - Airway: RSI.

CP:

• Ensure completion of all applicable items above.
• Refer to MIH Protocol 4-125 - Chronic Heart Failure Management.

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