Short Stay Management of Acute Heart Failure

316 Pages·2017·5.76 MB·English

by  W. Frank Peacock (eds.)

Contemporary Cardiology
Series Editor: Christopher P. Cannon
W. Frank Peacock Editor
Short Stay
Management
of Acute Heart
Failure
Third Edition
Contemporary Cardiology
Series editor
Christopher P. Cannon
Boston, Massachusetts, USA
For more than a decade, cardiologists have relied on Chris Cannon's Contemporary
Cardiology series to provide them with forefront medical references on all aspects
of cardiology. Each title is carefully crafted by world-renown cardiologists who
comprehensively cover the most important topics in this rapidly advancing field.
With over 60 titles in print covering everything from diabetes and cardiovascular
disease to the management of acute coronary syndromes, the Contemporary
Cardiology series has become the leading reference source for the practice of
cardiac care.
More information about this series at http://www.springer.com/series/7677
W. Frank Peacock
Editor
Short Stay Management
of Acute Heart Failure
Third Edition
Editor
W. Frank Peacock
Department of Emergency Medicine
Baylor College of Medicine
HOUSTON
Texas
USA
ISSN 2196-8969 ISSN 2196-8977 (electronic)
Contemporary Cardiology
ISBN 978-3-319-44005-7 ISBN 978-3-319-44006-4 (eBook)
DOI 10.1007/978-3-319-44006-4
Library of Congress Control Number: 2016963565
© Springer International Publishing Switzerland 2017
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfilms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made.
Printed on acid-free paper
This Humana Press imprint is published by Springer Nature
The registered company is Springer International Publishing AG Switzerland
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
Heart failure is the most common reason for patients over the age of 65 to be hospi-
talized. It is the most common reason for their re-hospitalization within the next 30
days, and after an emergency department visit that results in hospitalization for
acute heart failure, the 2-year mortality rate approaches 50 %. This is not a disease
anyone wants to have, and it is occurring more frequently at an alarming rate. Heart
failure is the final common pathway of an aging population and a consequence of
the remarkable success that has been attained in managing the other chronic cardio-
vascular diseases that historically resulted in an early mortality before the presence
of heart failure could be realized.
Heart failure is expensive. In fact, it is the number one most expensive diagnosis,
as reported by the Centers for Medicare and Medicaid Studies. As a country, the
United States spends more on heart failure than any two cancers combined, a fact
that just represents the financial costs. From a quality of life perspective, patients
with advanced heart failure are miserable. Symptoms include shortness of breath
with the slightest effort, sleeping disorders, and the inability to eat or drink nor-
mally. This is not a symptom constellation that is easily ignored or appreciated.
Short Stay Management of Acute Heart Failure, Third Edition, presents opportu-
nities for improving the management of patients likely to have, and ultimately be
diagnosed with, acute heart failure. Few patients wish to be in the hospital. It is only
when the severity of their illness makes it impossible to stay at home do they present
and ask for help. By focusing on rapid diagnosis, early intervention, and stabiliza-
tion, followed by symptom relief and optimization of life-prolonging therapies, a
short stay strategy has the potential to maximize the quality of life for the patient.
Quality of days alive and outside of the hospital is the measure by which patients
will judge our successes in their care. The authors of this text hope that you will find
it useful in providing the best outcomes possible for your heart failure patients.
Houston, TX, USA W. Frank Peacock, MD, FACEP, FACC
v
Contents
Part I Administrative and Regulatory Issues
1 Society of Cardiovascular Patient Care Heart
Failure Accreditation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Maghee Disch
2 The Economics and Reimbursement of Congestive Heart
Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Sandra Sieck
3 Regulatory Requirements in Acute Heart Failure . . . . . . . . . . . . . . . . . 29
Nancy M. Albert
4 Quality and Operational Metrics in Heart Failure . . . . . . . . . . . . . . . . 45
Donna Hunn, Phillip D. Levy, Matthew A. Wheatley,
and Maghee F. Disch
5 Interaction of Performance Measurements, Staffing,
and Facility Requirements for the Heart Failure
Observation Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Valorie Sweigart and Karen Krechmery
Part II Pathophysiology and Demographics
6 Heart Failure: Epidemiology and Demographics . . . . . . . . . . . . . . . . . 69
Karina M. Soto-Ruiz
7 P athophysiology of Acute Decompensated Heart Failure . . . . . . . . . . . 81
Ezra A. Amsterdam, Sandhya Venugopal, and Angela Thinda
Part III Emergency Medical Services and Emergency
Department Assessment and Treatment of Acute Heart Failure
8 T he Out-of-Hospital Management of Acute Heart Failure . . . . . . . . . . 91
Andrew M. McCoy, Richard B. Utarnachitt,
and Marvin A. Wayne
vii
viii Contents
9 Dyspnea Assessment and Airway Management
in Acute Heart Failure Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Gina DiAntonio Swartzel and Peter S. Pang
10 Volume Assessment in Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Anna Marie Chang and Alfred B. Cheng
11 Emergency Department Ultrasound as a Diagnostic
and Therapeutic Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Jennifer Carnell
12 Diagnostic and Prognostic Biomarkers in Emergency
Department Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Yang Xue, Arrash Fard, Navaid Iqbal, Alan Maisel,
and Nicholas Wettersten
13 Emergency Department Therapy of Acute Heart Failure . . . . . . . . . 165
Carlos E. Velasco, Deborah Diercks,
and Phillip D. Levy
Part IV Observation Unit Treatment and Disposition
14 O bservation Unit Admission Inclusion and Exclusion Criteria . . . . . 187
Jason M. Hogan, Sean Collins, and Gregory J. Fermann
15 A cute Decompensated Heart Failure in the Observation
Unit: Treatment Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
John Pease
16 E ducation Elements in the Observation Unit for Heart
Failure Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Brad P. Mayeux and Robin J. Trupp
17 E mergency Department and Observation Unit Discharge
Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Kevan E. Meadors and Deborah B. Diercks
18 E ffective Discharge Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
Sudha P. Jaganathan, Ginger Conway, and Stephanie Dunlap
19 O utpatient Medication Titration in Acute Heart Failure . . . . . . . . . . 243
Juan R. Vilaro and David E. Winchester
Part V Complications and Future Research
20 D rugs to Avoid in Acute Decompensated Heart
Failure (ADHF): Contraindicated Medications
and Interactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Lindsey Aurora and James McCord
Contents ix
21 Implications of Atrial Fibrillation in Heart Failure
Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Chad E. Darling and David D. McManus
22 Cardiac Implantable Electronic Devices . . . . . . . . . . . . . . . . . . . . . . . . 285
Brian Hiestand
23 Heart Failure and Kidney Disease: Management
in the Short-Stay Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Shahriar Dadkhah and Korosh Sharain
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
Contributors
Nancy M. Albert, PhD, CCNS, CCRN, NE-BC, FAHA Nursing Research and
Innovation, Nursing Institute and Clinical Nurse Specialist, Kaufman Center for
Heart Failure, Cleveland, OH, USA
Ezra A. Amsterdam, MD Division of Cardiovascular Medicine, Department of
Internal Medicine, Davis Medical Center, University of California, Sacramento,
CA, USA
Jennifer Carnell Department of Emergency Medicine, Baylor College of
Medicine, Houston, TX, USA
Anna Marie Chang, MD, MSCE Thomas Jefferson University, Philadelphia,
PA, USA
Alfred B. Cheng Cooper University Hospital, Camden, NJ, USA
Ginger Conway, RN, MSN, CNP Division Cardiovascular Health and Disease,
University of Cincinnati Medical Center, Cincinnati, OH, USA
Shahriar Dadkhah, MD, FACC Section of Cardiology, Presence Saint Francis
Hospital, Evanston, IL, USA
Chad E. Darling, MD Department of Emergency Medicine, University of
Massachusetts Medical School, Worcester, MA, USA
Deborah B. Diercks, MD, MSc, FACEP Department of Emergency Medicine,
University of California, Davis Medical Center, Sacramento, CA, USA
Maghee F. Disch, MSN, RN, CNL, CHFN, AACC Society of Cardiovascular
Patient Care, Dublin, OH, USA
Stephanie Dunlap, DO Advanced Heart Failure Program, University of
Cincinnati Medical Center, Cincinnati, OH, USA
Arrash Fard, MD VA San Diego Healthcare System, San Diego, CA, USA
Gregory J. Fermann, MD Department of Emergency Medicine, University of
Cincinnati, Cincinnati, OH, USA
xi