Heart Failure in Adults. Emergent Management Algorithm.

[Return to algorithm box #5, Admit to Hospital if Necessary]

[See Acute Pulmonary Edema algorithm]

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Source: Institute for Clinical Systems Improvement (ICSI). Heart failure in adults. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2007 Aug. 119 p. Heart Failure in Adults Emergent Management Algorithm Unstable signs and symptoms requiring emergent management are present A = Annotation Initial patient assessment. A Airway problem? Follow ACLS algorithms for securing airway Initiate O2 therapy, start IV, order labs, chest x-ray and ECG. Consider ECHO. A Oxygen and ventilation adequate? Adjust O2 delivery. Consider CPAP/bilevel positive airway pressure. (BiPAP)/intubation follow ACC/AHA guidelines. A Arrhythmia? Follow ACLS algorithms for brady- or tachycardia Acute coronary syndrome? Out of guideline. Consultation. Consider angiography. Assess blood pressure, perfusion, and volume status Cardiogenic shock BP less than 70 mmHg. Signs/symptoms of shock. *Norepinephrine. BP 70-100 mmHg. Signs/symptoms of shock. *Dopamine. BP 70-100 mgHg. No signs/symptoms of shock. *Dobutamine. BP greater than 100 mmHg without acute pulmonary edema or cardiogenic shock, return to algorithm box #5, "Admit to Hospital if Necessary" Acute pulmonary edema BP greater than 100 mmHg. A Out of guideline See Acute Pulmonary Edema algorithm All copyrights are reserved by the Institute for Clinical Systems Improvement, Inc.