Prehospital management of congestive heart failure.
The evolution of prehospital treatment of decompensated congestive heart failure has in some ways come full circle: rather than emphasizing a battery of new pharmacotherapies, out-of-hospital providers have a renewed focus on aggressive use of nitrates, optimization of airway support, and rapid transport. The use of furosemide and morphine has become de-emphasized, and a flurry of research activity and excitement revolves around the use of noninvasive positive-pressure ventilation. Further research will clarify the role of bronchodilators and angiotensin-converting enzyme inhibitors in the prehospital setting.
Mattu
Amal
A
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA. amattu@smail.umaryland.edu
Lawner
Benjamin
B
D022561:Advanced Cardiac Life Support; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002985:Clinical Protocols; D015897:Comorbidity; D004232:Diuretics / Q000008:administration & dosage; D004632:Emergency Medical Services; D005665:Furosemide / Q000008:administration & dosage; D006333:Heart Failure / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008396:Maryland; D005996:Nitroglycerin / Q000008:administration & dosage; D011175:Positive-Pressure Respiration
D000806:Angiotensin-Converting Enzyme Inhibitors; D001993:Bronchodilator Agents; D004232:Diuretics; D005665:Furosemide; D005996:Nitroglycerin