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ModerateEmergencyAcute pulmonary oedemauk-plab-1

A 47-year-old woman with known heart failure with reduced ejection fraction presents with acute shortness of breath, orthopnoea and pink frothy sputum. On examination she has bilateral crackles to mid-zones and is tachycardic. Blood pressure is 160/95 mmHg and oxygen saturation is 88% on air. What is the most appropriate immediate management in A&E?

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