This is the first of what we hope will be a permanent feature, of the Roadside to Resus podcasts. We’ve been joined by James Yates, a Critical Care Paramedic with the Great Western Air Ambulance to make it a truly multidisciplinary team. Each monthly episode we’ll be discussing acute presentations, including the latest and most influential evidence base surrounding them. We really want to break down some barriers between pre-hospital and in hospital teams and it soon becomes evident in this first podcast that many of the problems we face are shared throughout the patient journey and across disciplines!
We’re starting off with Acute Heart Failure and in the podcast we run through;
- The underlying physiology and help explain the different problems we may find in each subset
- The keys to diagnosis, including the most predictive parts of history and examination
- We discuss the evidence base for treatment and the trends of use both pre and in-hospital
- We talk about CPAP and whether the evidence supports it’s use
- Finally, the direction that further treatment in the UK may move
Heart failure is a hugely common problem and when patients present in Acute Heart Failure (AHF) they can be BIG sick.
It can be easy to think of the term AHF as an ultimate diagnosis, but getting upper in and a really good grip on the physiology leading to the failure of the cardiovascular system mean we can really tailor evaluation and treatment to the specific area our patients are suffering with.
First of all, whats the definition? Well the European Society of Cardiology (ESC) clarify it as the following;
AHF refers to rapid onset or worsening of symptoms and/or signs of HF. It is a life-threatening medical condition requiring urgent evaluation and treatment, typically leading to urgent hospital admission.
AHF may present as a first occurrence (de novo) or, more frequently, as a consequence of acute decompensation of chronic HF, and may be caused by primary cardiac dysfunction or precipitated by extrinsic factors, often in patients with chronic HF.
The ESC sub categorises AHF as follows, we refer to this in the podcast.
Once again we hope you find the podcast useful. Get in touch with any comments, questions or suggestions for further topics. Most of all don’t take our word for it, but make sure you delve into the references yourself and make up your own mind.
References & Further Reading
Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine