Algorithm for management of acute

pulmonary oedema
(adapted from ESC Guidelines 2012)

Acute pulmonary oedema/congestion

50mg IV furosemide

Yes
Hypoxaemia Oxygen

Yes
Severe distress Consider IV opiate

Measure systolic BP

SBP <85mmHg or shock SBP 85-110mmHg SBP >110mmHg

Potentially for consideration of No additional therapy until Consider GTN infusion

inotropic support – discuss with response addressed
Cardiology

Yes
Responding to Rx? Continue current Rx

Consider other measures –

bladder catheterisation,
CPAP, suitability for invasive
ventilation. Seek senior help

A Robertson, S Hutcheon
Acknowledgements: ESC Guidelines 2012
Created: October 2012 Review: October 2014