Heart Failure - Level 4A

62-year-old male patient with chronic heart failure admitted to the hospital yesterday for dehydration, for which he received IV Fluids, resulting in the development of pulmonary edema. Two hours prior to the start of this shift, the nurse administered STAT IV furosemide. The patient refuses to wear his BiPAP or non-rebreather mask. Before administering scheduled medications, students should notice that lab work has not been drawn since prior to the administration of IV Lasix. The patient begins to develop chest pressure and students should obtain a STAT ECG, which shows the development of PVCs. A 5-minute timer begins, and as the patient becomes increasingly more confused, he goes into Vfib 5 minutes later as the rapid response team arrives. The facilitator can then lead the students in performing CPR and assisting in a “code” situation.