Emergency Management of Acute Heart Failure
Aug 11, 2021
Source: Cainiu Health
Dr. Zhang Min
Introduction
Emergency management of acute heart failure primarily includes the following measures:
1. Position the patient in an upright sitting position with both legs dangling over the edge of the bed, and provide reassurance.
2. Administer high-flow oxygen.
3. Instruct the patient to avoid excessive fluid intake.
4. Initiate pharmacotherapy for heart failure, such as positive inotropic and diuretic agents.
5. Rapidly reduce blood pressure to target levels.
First, position the patient in an upright sitting posture with both legs dangling over the edge of the bed. Provide reassurance to alleviate excessive anxiety, tension, or fear.
Second, administer high-flow oxygen therapy to relieve systemic hypoxia.
Third, advise the patient to limit fluid intake, as excessive water consumption increases intravascular volume and may exacerbate heart failure.
Fourth, administer anti-heart-failure medications, such as positive inotropes and diuretics. Morphine is widely recognized as a highly effective agent for acute left-sided heart failure due to its sedative and analgesic effects, reduction of myocardial oxygen demand, vasodilatory action, and ability to decrease both preload and afterload on the heart.
Fifth, rapidly lower the patient’s blood pressure to the target range, since elevated blood pressure increases cardiac afterload, thereby impeding correction of heart failure.
