EMRA Simulation Guide

CARDIOVASCULAR - CHF Exacerbation

CASE: 55-year-old male presents with worsening dyspnea

Learning Objectives

1. Recognize the symptoms that a patient with CHF exacerbation may display
2. Learn to employ a systematic approach to a dyspneic patient
3. Create a differential diagnosis for dyspnea
4. Understand the initial management of CHF exacerbation
5. Develop a basic understanding of the steps in oxygen escalation therapy

Critical Actions

• IV access x2
• Supplemental oxygen
• Non-rebreather
• Non-invasive positive pressure ventilation (CPAP or BiPAP)
• Telemetry monitoring
• Patient history
• Physical exam
• Ask for crash cart
• EKG
• CXR
• Labs: CBC, coagulation profile, BMP, cardiac biomarkers, BNP
• Furosemide IV
• Reassessment of vitals
• Consults called
• Closed-loop communication
• Summarize case to team and/or consultant

Download the case here.