medic001918 Posted March 25, 2006 Posted March 25, 2006 The topic of albuterol in CHF patients is highly controversial, as is many aspects of medicine. I will occasionally give it in patients with a CHF exacerbation. But there are a few things that I have to get done before I will go ahead and do that. In any CHF case, one of the most beneficial drugs we can supply a patient is nitro. These patients need to be hit hard with the nitrates and keep them going. I also do a 12-lead as one of my first steps to help rule out an MI. I also want to make sure that I secure IV access and push lasix (or bumex) before giving a breathing treatment. Morphine is always an option for the vasodilation effects, but more importantly for the CNS depression that it causes. This will often take a very anxious patient and bring them down a little bit allowing for more effective ventilation. This is especially helpful if you need to ventilate via BVM. Occasionally I will give a breathing treatment. If a patient has spent some time in CHF with fluid in the pulmonary system, this is enough to cause an inflammation or a form of bronchoconstriction that the albuterol treatment may help with. The breathing treatment is commonly the last step in my treatment of a patient with a CHF event going on. Shane NREMT-P
medic429 Posted March 25, 2006 Posted March 25, 2006 The topic of albuterol in CHF patients is highly controversial, as is many aspects of medicine. I will occasionally give it in patients with a CHF exacerbation. But there are a few things that I have to get done before I will go ahead and do that. In any CHF case, one of the most beneficial drugs we can supply a patient is nitro. These patients need to be hit hard with the nitrates and keep them going. I also do a 12-lead as one of my first steps to help rule out an MI. I also want to make sure that I secure IV access and push lasix (or bumex) before giving a breathing treatment. The breathing treatment is commonly the last step in my treatment of a patient with a CHF event going on. Shane NREMT-P ditto here--nitrates and lasix before albuterol....
Ace844 Posted March 25, 2006 Posted March 25, 2006 out here, ACE844 Yes out there in left field, baited, hook line and sinker. Should I call on Letterman to tune you up? I'm curious "squint, squirt, squat," whatever nome de guerre you prefer today. Do you even have "Letterman," in the wild of whatever forest you peer into all day?!?! :wink: 8) Baited, not so much as playing along for my own school yard enteratinment..I always enjoy the flux that comes with your transient senility... Lets get this straight OK.....! 1-its squint not squirm...that's funny right? you slay me! See above 2- Chronotropy you mean + not - forgive me' date=' nope did read all the rhetoric sorry....kill me please.[/quote'] Yes I did mean positive, as in a possibly undesirable (in this pt) side effect of the admin of this particular med..
Dustdevil Posted March 25, 2006 Posted March 25, 2006 Ace, check your computer. There's something wrong. The dozen movie clip photos weren't attached to that last post.
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