506 ACUTE PULMONARY EDEMA

1. Begin Basic Life Support Respiratory Distress procedures.

2. Begin Cardiac Monitoring, record and evaluate EKG strip.

3. Begin an IV infusion of Dextrose 5% in (D5W) to keep vein open. Monitor vital signs every 2-3 minutes.

4. Contact Medical Control for implementation of one or more of the following options:

MEDICAL CONTROL OPTIONS

OPTION A:

Administer Nitroglycerine 1/150 gr sublingually. If there is no response to the initial dose of Nitroglycerine within 5 minutes, and vital signs remain stable, a repeat dose of Nitroglycerine 1/150 gr sublingually, may be given.

• NOTE:
  NITROGLYCERlNE MAY NOT BE ADMINISTERED TO PATIENTS WITH A SYSTOLIC BLOOD PRESSURE OF LESS THAN 120 mm Hg, UNLESS AN IV IS IN PLACE.

OPTION B:

Administer Furosemide 40-80 mg, IV bolus.

OPTION C:

Administer Morphine Sulfate 2.0-5.0 mg, IV bolus. Repeat doses of Morphine Sulfate 2.0-5.0 mg, IV bolus, may be given as necessary. (Maximum total dosage is 15 mg.)

• NOTE:
  IF HYPOTENSION, HYPOVENTILATION, OR STUPOR DEVELOPS DURING ADMINISTRATION OF MORPHINE SULFATE, WITHHOLD MORPHINE SULFATE, ELEVATE THE LEGS, AND ADMINISTER NALOXONE 2.0 mg, IV BOLUS.

OPTION D:

Transportation decision.

---

Contents