Let’s dive into one of the most crucial topics in EMS–heart failure and pulmonary edema. By the end of this session, you’ll have a solid understanding of this condition, which is vital for your EMS career.

Pulmonary Edema

This is when fluid accumulates in the bases of the lungs. It fills the alveoli, the tiny air sacs at the bottom of the lungs, and disrupts the gas exchange process. As a result, oxygen can’t get in, and carbon dioxide can’t get out efficiently, causing the patient to become hypoxic.

Symptoms include low SpO2 levels, chest pain, and difficulty breathing, often leading to a call for an ambulance.

Congestive Heart Failure (CHF)

When the heart fails to pump blood effectively, it can lead to pulmonary edema. Blood that should move forward instead backs up, causing issues. Conditions like myocardial infarction (heart attack), valve failure, and chronically weak ventricles can all lead to heart failure.

Left-Sided Heart Failure

The left ventricle pumps blood out to the body. If it fails, blood backs up in the pulmonary veins, leading to increased pressure and fluid leaking into the alveoli. Symptoms include poor gas exchange and bilateral crackles (rails) heard through a stethoscope.

Right-Sided Heart Failure

If the right ventricle fails, blood backs up in the superior and inferior vena cava, causing venous congestion. Symptoms include jugular vein distension (JVD) and pedal edema (swelling in the legs).

Recognizing Congestive Heart Failure (CHF)

Key Signs and Symptoms of CHF:

  • Chest Pain: Related to the heart and lungs.
  • Shortness of Breath: Increased respiratory rate, decreased SpO2, and bilateral crackles.
  • Fatigue and Weakness: The patient isn’t feeling like themselves.
  • Edema: Swelling in the legs and JVD.
  • Inability to Perform Daily Activities: Due to shortness of breath and fatigue.
  • Difficulty Sleeping: Often waking up short of breath and needing to call 911.

When you encounter these signs, perform an EKG to investigate the patient’s condition further. Remember, CHF isn’t just about fluid in the lungs; the patient could also be experiencing a heart attack.

Stay sharp and attentive to these symptoms. Your quick and accurate assessment can make all the difference in effectively managing heart failure.