Acute pulmonary oedema — DipIMC MCQ

Correct answer: E — Give oxygen, consider nitrates within protocol and transport urgently

Give oxygen, consider nitrates within protocol and transport urgently is the best answer because hypertensive pulmonary oedema requires oxygenation, afterload reduction when appropriate and urgent hospital care. Provide reassurance and reassess after transport is less appropriate because reassurance is inadequate for an evolving major trauma problem; Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled. Use oral analgesia as the main treatment and Defer treatment until a senior hospital doctor reviews the patient are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Acute Heart Failure guidance