Tag Archives: CHF

Bloodtest Not Pertinent (BNP)

Despite a lack of evidence that it’s useful, many emergency departments have introduced BNP testing. Some smart Australians decided to properly evaluate its benefit the best way possible – with a randomised controlled trial on 612 patients with acute severe dyspnoea. Guess what? Clinician knowledge of BNP values in patients who presented with shortness of breath to the emergency department did not reduce the probability of hospital admission or alter management or length of hospital stay. The study findings do not support indiscriminate BNP testing in all dyspnoea patients, but do not rule out a possible role in patients with milder dyspnoea.
B-type natriuretic peptide testing, clinical outcomes, and health services use in emergency department patients with dyspnea: a randomized trial
Ann Intern Med. 2009 Mar 17;150(6):365-71

Nurse-delivered prehospital CPAP

A nurse-based pre-hospital care system in Holland describes its experience with pre-hospital CPAP for acute cardiogenic pulmonary oedema. It appears that the simple Boussignac apparatus is straightforward to apply in the ambulance environment. Arguments about lack of outcome studies aside, if it’s necessary to undertake an interhospital transfer of a patient established on CPAP then this might be a relatively straightforward means of doing so.
http://www.ncbi.nlm.nih.gov/pubmed/19164632?dopt=Abstract