Initial Medical Management Plan for Hospital Care

Initial Assessment and Stabilization

The European Society of Cardiology recommends determining cardiopulmonary stability as the critical first step, with patients having respiratory failure or hemodynamic compromise triaged to a location where immediate respiratory and cardiovascular support can be provided 2
The European Society of Cardiology suggests establishing continuous monitoring including pulse oximetry, blood pressure, respiratory rate, and continuous ECG within minutes of patient contact 3
The European Society of Cardiology recommends maintaining SpO₂ >90%, systolic blood pressure >90 mmHg, and adequate peripheral perfusion as primary treatment objectives 4
The European Society of Cardiology recommends assessing mental status using the AVPU (alert, visual, pain, or unresponsive) mnemonic as an indicator of hypoperfusion 2

The European Society of Cardiology recommends obtaining immediate laboratory tests including complete blood count, electrolytes, BUN/creatinine, glucose, and cardiac biomarkers (troponin) 5
The European Society of Cardiology suggests performing ECG to exclude ST elevation myocardial infarction and assess for other cardiac abnormalities 5
The European Society of Cardiology recommends ordering chest X-ray to rule out alternative causes of respiratory symptoms, recognizing that in some conditions like acute heart failure, it may be normal in up to 20% of cases 2

The European Society of Cardiology recommends administering oxygen therapy for patients with SpO₂ <90% 5
The European Society of Cardiology suggests initiating non-invasive ventilation for patients with respiratory distress to decrease work of breathing and reduce the need for endotracheal intubation 5
The European Society of Cardiology recommends beginning medical treatment based on blood pressure and degree of congestion using vasodilators and/or diuretics (furosemide) 3

The European Society of Cardiology recommends monitoring dyspnea (using visual analog scale), respiratory rate, blood pressure, SpO₂, heart rate and rhythm, urine output, and peripheral perfusion 4
The American Diabetes Association recommends targeting blood glucose range of 80-180 mg/dL (4.4-10.0 mmol/L) in the perioperative period 7

The American College of Obstetricians and Gynecologists recommends using blood products rather than crystalloid or colloid fluids for volume resuscitation to avoid fluid overload in amniotic fluid embolism management 8
The American College of Obstetricians and Gynecologists suggests considering inotropes and pulmonary vasodilators as mainstays of management in amniotic fluid embolism management 8