title: Pulmonary oedema--prehospital treatment. Caution with morphine dosage.
abstract: OBJECTIVE
  To inform doctors of potential hazards if opioids are administered in excessive doses to patients with acute pulmonary oedema.
  
  
  METHODS
  Three elderly patients were unresponsive and hypotensive on arrival in the emergency department. All had received morphine parenterally as a component of prehospital treatment for acute pulmonary oedema.
  
  
  RESULTS
  All were given naloxone intravenously, regained consciousness and had a rise in blood pressure.
  
  
  CONCLUSIONS
  Parenteral administration of opioids should be used with caution in acute pulmonary oedema. The authors present a protocol for prehospital drug therapy.
authors.affiliation: Flinders Medical Centre, Adelaide, SA.
authors.forename: J A
authors.initials: JA
authors.lastname: Chambers
authors.forename: C J
authors.initials: CJ
authors.lastname: Baggoley
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services; D005194:Family Practice; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D011654:Pulmonary Edema / Q000188:drug therapy* / Q000503:physiopathology; D013021:South Australia; D014474:Unconsciousness / Q000139:chemically induced
chemical_list: D009020:Morphine