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Although there is no proven link between early diuretic administration and improved outcome in patients with congestive heart failure (CHF), diuretic use is common in the prehospital setting. Little is known about the appropriateness or benefits of this practice. Using a database from a single emergency medical service, investigators identified all instances of prehospital furosemide use during a 12-month period and reviewed patients’ emergency department and hospital charts.
Furosemide use was deemed appropriate when the primary or secondary ED or hospital diagnosis included CHF or pulmonary edema, or when the brain-type natriuretic peptide (BNP) level was >400 pg/mL. Use was deemed inappropriate when the diagnoses did not include CHF or pu…