As their hypoxia worsens they may become agitated and with worsening respiratory failure may become hypercapnoeic causing their conscious level to fall. [rcemlearning.co.uk]

[…] striking feature of acute pulmonary edema: when the work of breathing is greatly intensified, increased ventilation may be associated with such large increases in CO 2 production from respiratory muscles that arterial pCO 2 actually rises instead of falling [academic.oup.com]

Infusion is commenced at 2-3mcg/kg/min and increased as required.(1) (d) Disability Morphine should be given early for patients who are agitated and distressed or complaining of chest pain. [rcemlearning.co.uk]

In each patient the onset of pulmonary edema was evidenced by acute dyspnea, cough, mental distress, and the development of râles throughout the lung fields. In one patient frothy pink sputum was expectorated. [annals.org]

ACS SOB Cough pink frothy sputum Dry cough Green sputum Haemoptysis Chest pain Palpitations Fever Sweating Acuity Nocturnal (ii) Clinical examination (see Box 1 and Table 2) Box 1: Typical examination findings in a patient with acute pulmonary oedema [rcemlearning.co.uk]

Signs and symptoms [ edit ] The most common symptom of pulmonary edema is difficulty breathing, but may include other symptoms such as coughing up blood (classically seen as pink, frothy sputum), excessive sweating, anxiety, and pale skin. [en.wikipedia.org]

Treatment of acute hypoxemic nonhypercapnic respiratory insufficiency with continuous positive airway pressure delivered by a face mask: a randomized controlled trial JAMA 2000 ; 284 : 2352 -2360. [25], Huberfeld S, Tarasiuk A, et al. [academic.oup.com]

Shortness of breath can manifest as orthopnea (inability to lie down flat due to breathlessness) and/or paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night). [en.wikipedia.org]

Specifically, their use may dehydrate the euvolaemic patient and cause hyponatraemia and hypotension. [rcemlearning.co.uk]

Cardiogenic shock (CS) is characterized by systemic hypoperfusion due to severe depression of the cardiac index ( 2 ) and sustained systolic arterial hypotension ( 18 mmHg). It is associated with in-hospital mortality rates 50%. [accessmedicine.mhmedical.com]

[…] has peripheral vasodilatory effects that can result in worsening hypotension, which may require management with a vasopressor. [ncbi.nlm.nih.gov]

Do not give opiate if patient is drowsy, exhausted or hypotensive. Give: furosemide IV 50mg (or in patients already receiving oral diuretics, give, intravenously, double the patient's normal oral dose). Repeat bolus at 30 mins to 1 hour. [handbook.ggcmedicines.org.uk]

The heart sounds may be inaudible over the rales from the lungs but a gallop rhythm may be present. Murmurs, especially mitral regurgitation and aortic stenosis, should be listened for, and may reveal a precipitating cause. [rcemlearning.co.uk]

Table 2 Recommended doses of furosemide (frusemide) Presentation and administration Dose Frequency Slow intravenous bolus 4 mg/min repeat after 20 min if necessary – normal renal function 40–80 mg – – renal insufficiency or severe heart failure up to [ncbi.nlm.nih.gov]

As their hypoxia worsens they may become agitated and with worsening respiratory failure may become hypercapnoeic causing their conscious level to fall. [rcemlearning.co.uk]

[…] correction). 18 A judgement on ventilatory performance based on respiratory pattern, such as the presence of a rapid-shallow breathing, is of uncertain reliability. 19–20 During APE various conditions other than respiratory fatigue, like hypoxemia, agitation [academic.oup.com]

Fig 4: Example ECG 1 in CPO Sinus Tachycardia with widespread T wave inversion and Q waves V1 and V2 Fig 5: Example ECG 2 in CPO Atrial flutter with 2:1 block Fig 6: Example ECG 3 Atrial fibrillation with ventricular ectopics and lateral T wave inversion [rcemlearning.co.uk]