Assessment in hospital

Assessment in hospital

 

Guidance on where to treat and manage the patient

Patient needs emergency care if they have:

  • New syncope or blackout
  • Ongoing chest pain/suspicion of acute MI
  • Possible CHAMPIT cause of AHF
  • Heart rate > 130
  • New BP < 90mmHg (refer to patients normal baseline)
  • New SpO2 < 90% (refer to patients normal baseline)
  • Pulmonary oedema
  • Patient declines IV therapy at home/safety concerns
  • No access to ambulatory or at home IV diuretic therapy

*‘Level 2’ care is defined as patients requiring more detailed observation or intervention including support for a single failing organ system or post-operative care and those ‘stepping down’ from higher levels of care

These patients require Emergency Admission and Possible Level 2 Care*

For other patients, consider treatment and management with specialist input in the community IF AVAILABLE.
NOTE: Local guidelines and services for the treatment and management of patients in the community vary. For example, some services will manage patients with worsening renal function or evidence of moderate fluid overload not responding to increased oral diuretics.
PLEASE SPEAK TO YOUR SPECIALIST – do not stop HF treatments without speaking to the HF Team

Where specialist input in the community is not available or required, consider managing and treating the patient in primary care if you have no safety concerns (clinical or social), the patient consents and they are haemodynamically stable.
If unsure, PLEASE SPEAK TO YOUR SPECIALIST - do not stop HF treatments without speaking to the Heart Failure Team.

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(c) British Society for Heart Failure, 2022-
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