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today were going to talk about the patient that presents with a CHF exacerbation how do you know when to intervene with lasix nitro BiPAP or other more aggressive therapies this will build on our prior lecture on the approach to the patient with shortness of breath so now that were ready lets go ahead and begin so like we did before or the first thing that you need to do is develop your critical differential diagnosis in this case thatll be pneumonia pneumothorax PE asthma COPD and CHF exacerbation we will assume that youve already figured out that this patient is in a CHF exacerbation maybe when you assess the patient you noted that they had jvd crackles at the bases of their lungs lorg feminie edema and swelling maybe the patient told you that they had dis me on exertion and PMD or maybe you went a step further and use the ultrasound to determine that the patient had a poor EF as well as a dilated IVC but in either case youve been called to a patient whos in some form of resp
