Brilliant and backs up a lot of what Ive learnt from clinical experience. The amount of time you see Frusemide being given and then absolutely nothing happening is scary. Also turns out Ive also been under-dosing GTN too eek!.
Nitro paste has very little if any place in the acute prehospital setting due to the high variability of onset time, as well as amount of medication that actually reaches systemic circulation. Sequential Nitro sprays titrated based pt BP and CPAP are you best prehospital options.
Doctor Mattu , you are an iconic figure in the field of emergency medicine and as a lifetimelearner of medicine I benefit very much from your knowledge and advice my colleauges to follow your invaluable lectures.I kindly ask you one point that I feel confused. Morphine , reduces the anxiety associated with the shortness of breath in these patients .Relieving this anxiety caused by feel like suffocating or imminent death feeling provides good management of these patients .Isn't it too early to say that ''morphine is history''?
Giving morphine for anxiety in this pt is equivalent to making them comfortable while they die. Theres much, much better interventions you could be doing for this pt during that time that actually help correct the underlying issues
