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• W2891783375 abstract "Introduction A 2016 retrospective chart review identified that a majority of patients who present with heart failure to our emergency department (ED) were not optimally diuresed. These results were shared with several emergency medicine physicians, which resulted in modifications in order entry for one-time intravenous furosemide doses. The primary objective of this study was to assess the timing of when a patient presented to the ED to when the first diuretic was administered. The secondary objectives were to assess the first diuretic dose ordered, total urine output in the first twelve hours, and length of stay. Methods This retrospective chart review approved by the Institutional Review Board was conducted on patients with a discharge diagnosis of heart failure from January 1, 2017 to July 31, 2017. Patients included in the study were at least 18 years of age and received a diuretic within the first 24 hours of admission to the ED. The electronic medical record system was used to collect the following patient-specific data: age, gender, length of stay, home diuretic dose, time arrival to the ED, type of diuretic and time of order, time of diuretic administration, and amount of diuresis. The final outcomes were time between patient arrival to the ED and administration of first diuretic, time between administration and first measurement of diuresis, and the amount of diuresis in milliliters. All data was analyzed using descriptive statistics. Results A total of 100 patient charts were captured in the time frame and included for analysis. The average time between arrival and diuretic order was 143 minutes, the average time to diuresis was 329 minutes, and the average diuresis volume was 1594 milliliters. Of the 100 patients included, 39 patients received furosemide 40 milligrams intravenously, 18 patients received furosemide 60 milligrams intravenously, and 39 patients received doses greater than 60 milligrams intravenously, ranging from 80 to 160 milligrams. After comparing the ED dose and recorded home dose of furosemide, results showed that 27 patients received the same dose and 25 patients received a higher dose. The average length of stay in patients who received an intravenous dose of furosemide equivalent to their prescribed home dose was about 5.9 days, while the patients who received a higher dose intravenously were hospitalized for about 4.6 days. Conclusion Administering diuretics in fluid overloaded patients helps relieve the symptoms associated with an acute exacerbation by causing prompt diuresis. Optimal diuresis may have a positive impact on patient outcomes and a decrease in their hospital length of stay." @default.
• W2891783375 created "2018-09-27" @default.
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• W2891783375 date "2018-08-01" @default.
• W2891783375 modified "2023-09-24" @default.
• W2891783375 title "Evaluation of Diuretics in Admitted Heart Failure Patients with Modification of Medication Order Entry" @default.
• W2891783375 doi "https://doi.org/10.1016/j.cardfail.2018.07.366" @default.
• W2891783375 hasPublicationYear "2018" @default.
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