APO CPG Notes Flashcards
(20 cards)
What is the role of nitrates in cardiogenic APO?
They treat the underlying cause and should be administered unless contraindicated.
What is the role of CPAP in APO?
It supports respiratory failure while the underlying cause is addressed.
When is Furosemide appropriate in APO?
Only in normotensive patients or after hypertension has resolved. Not a first-line treatment.
What is this CPG primarily directed at?
Symptomatic cardiogenic APO secondary to LVF or CCF.
What are examples of non-cardiac APO causes?
• Smoke/toxic gas inhalation
• Near drowning
• Aspiration
• Anaphylaxis
How should non-cardiac APO be treated?
With supplemental O₂ and assisted ventilation, not nitrates.
How should chest pain in APO be managed?
As per CPG A0401 Acute Coronary Syndrome.
When should Furosemide be used cautiously?
In hypotensive patients.
How should wheeze in pulmonary oedema be managed?
Only as per CPG A0601 Asthma if bronchospasm Hx confirmed.
What drug should be avoided in pulmonary oedema?
Salbutamol.
List four contraindications to CPAP.
• Inability to manage airway
• Upper airway obstruction
• Hypoventilation
• Untreated tension pneumothorax
• Haemodynamic instability
• Injuries preventing mask seal.
Who must observe a patient on BiPAP?
At least one MICA paramedic.
What must any extrication plan include for BiPAP patients?
Incorporation of continuous observation.
List 3 indications for removing CPAP or BiPAP.
• Ineffective treatment
• Deteriorating vital signs
• Risk to patient (vomiting, loss of airway, secretions).
What FiO₂ should BiPAP start at?
FiO₂ = 1.0.
How should FiO₂ be adjusted?
Titrate to normalise SpO₂, based on presentation/pathology.
Can NIV be used in patients who declined intubation?
Yes – if intubation is clinically indicated but declined by ACD.
What if an ALS paramedic attends and CPAP is effective?
Continue CPAP.
What if CPAP is not effective for ALS paramedic?
Switch to BiPAP.
When MICA attends, what should be applied first?
BiPAP – start with 10 cmH₂O PEEP.
