A 68-year-old woman presents as triage level 1 with severe dyspnea. BP is 224/118 mm Hg, HR 128/min, RR 34/min, oxygen saturation 82% on room air,

Question

A 68-year-old woman presents as triage level 1 with severe dyspnea. BP is 224/118 mm Hg, HR 128/min, RR 34/min, oxygen saturation 82% on room air, diffuse crackles, and ECG without STEMI. Which of the following is the most appropriate next step in management?

Accepted Answer

Noninvasive ventilation plus high-dose nitroglycerin

Answer

Large-volume normal saline bolus

Answer

Albuterol nebulizers and oral prednisone

Answer

IV beta-blocker and outpatient follow-up

Answer

Immediate endotracheal intubation before vasodilator therapy

Sympathetic crashing acute pulmonary edema — ABEM Board MCQ

A 68-year-old woman presents as triage level 1 with severe dyspnea. BP is 224/118 mm Hg, HR 128/min, RR 34/min, oxygen saturation 82% on room air, diffuse crackles, and ECG without STEMI. Which of the following is the most appropriate next step in management?