MAGEZI

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PULMONARY OEDEMA

Posted by SAMUEL ISABIRYE on February 5, 2013 at 4:55 PM

Congestion of the lung tissue with fluid

 

Cause

 

z

Cardiogenic: CCF

z

Inflammatory diseases, eg. cancer, TB

z

Fibrotic changes

 

Clinical features

 

z

Dyspnoea, breathlessness

z

Rapid breathing rate

z

Cough with frothy blood stained sputum

 

Differential diagnosis

 

z

Pneumonia

z

Plural effusion

z

Foreign body

z

Trauma

 

Investigations

 

¾

Chest X-ray

¾

ECG

¾

Echocardiography

 

Management H

Acute

 

f

Find cause of left ventricular failure & treat

 

accordingly

f

Give high concentration oxygen

f

plus furosemide 40-80mg IM or slow IV

 

- repeat prn up to 2 hourly according to response

- doses >50mg should be given by IV infusion

child: 0.5-1.5mg/kg daily (max: 20mg daily)

f

plus glyceryl trinitrate 500mcg sublingually

every 4-6 hours

 

UCG 2010 206

 

 

 

9. Cardiovascular diseases

f

Give morphine 5-15mg IM or 2-4mg slow IV

child: 0.1mgs/kg slow IV single dose

 

f

plus prochlorperazine 12.5mg by deep IM

 

- avoid in children

f

Repeat these every 4-6 hours till there is

improvement

 

Caution

 

U

No digitalization if patient has had digoxin within

the past 14 days but give maintenance dose

 

Prevention

 

z

Early diagnosis and treatment of cardiac

conditions, respiratory tract infections

 

z

Avoid (narcotic) medicine abuse

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