- •When patients are diagnosed with decompensated heart failure and signs or symptoms of hypervolemia, they require an intravenous bolus of a loop diuretic that should be equal to the total daily dose prescribed for home use and if not on a loop diuretic, 40 mg dose of furosemide or the equivalent dose of another loop diuretic agent.
- •In this study, emergency department providers under-dosed the initial loop diuretic administered, which could have increased the need for acute hospitalization.
- •Emergency department provider teams and leaders should develop algorithms and quality improvement metrics to enhance adherence to national guideline diuretic recommendations.
Abbreviations:ACCF (American College of Cardiology Foundation), ACEi (angiotensin converting enzyme inhibitor), AHA (American Heart Association), ARB (angiotensin receptor blocker), ARNI (angiotensin receptor neprilysin inhibitor), ED (emergency department), eMR (electronic medical record), HF (heart failure), HFpEF (heart failure with preserved ejection fraction), HFrEF (heart failure with reduced ejection fraction), HFSA (Heart Failure Society of America), SD (standard deviation), US (United States)
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Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.