Management of acute heart failure in the emergency department
Rob Fenwick Trainee advanced clinical practitioner, Emergency department, Heart of England NHS Foundation Trust
Rob Fenwick suggests an alternative to the National Institute for Health and Care Excellence guidelines for treating patients who have heart failure with pulmonary oedema
Acute heart failure (AHF) is a leading cause of hospital admission in the UK and is associated with significant mortality. The National Institute for Health and Care Excellence (2014) has published guidelines for the management of AHF but, after a clinical event in which a patient’s management differed from that recommended in the guidelines occurred in the author’s emergency department, he conducted a critical analysis of them. This article provides a case study of the clinical event, reviews the treatment methods adopted and explores the rationale for taking a different approach from that recommended in the guidelines. The evidence base for the use of diuretics, nitrates and non-invasive ventilation in the management of patients with AHF is also appraised.
23, 8, 26-35.
This article has been subject to double-blind review and has been checked using antiplagiarism software
Conflict of interest
Received: 16 September 2015
Accepted: 09 November 2015
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