Pulmonary oedema--prehospital treatment. Caution with morphine dosage.

OBJECTIVE

To inform doctors of potential hazards if opioids are administered in excessive doses to patients with acute pulmonary oedema.

CLINICAL FEATURES: Three elderly patients were unresponsive and hypotensive on arrival in the emergency department. All had received morphine parenterally as a component of prehospital treatment for acute pulmonary oedema.

INTERVENTIONS AND OUTCOME: All were given naloxone intravenously, regained consciousness and had a rise in blood pressure.

CONCLUSION

Parenteral administration of opioids should be used with caution in acute pulmonary oedema. The authors present a protocol for prehospital drug therapy.