Table 1.

Initial Approach to ED patients with HF identifying important acute precipitants, hemodynamics, and other contributing conditions

Prognostic Factor	Assessment	ED Intervention
Acute Precipitants
Ischemia	ECG and troponin	Antiplatelet, reperfusion, nitroglycerin
Infection	Chest radiograph, physical exam, urinalysis	Antibiotics, occasionally intravenous fluids
Arrhythmia	ECG	Rate and rhythm control via pharmacotherapy or electrical cardioversion
Hemodynamics
Hypotension	Vital signs	Intravenous fluids, vasopressors, inotropes
Hypoxia	Pulse oximetry	Oxygen, NIV, intubation
Organ perfusion	Mental status, capillary refill	Intravenous fluids, vasopressors, inotropes
Contributing Conditions
Renal dysfunction	BUN, creatinine	Vasodilators, diuresis, intravenous fluids
Hyponatremia	Serum sodium level	Fluid restriction
COPD	Pulse oximetry	Bronchodilators, steroids, oxygen
Diabetes	Blood glucose	Insulin, oral hypoglycemic agents

BUN: blood urea nitrogen; COPD: chronic obstructive pulmonary disease; ECG: electrocardiography; NIV= non-invasive ventilation;