Core EM - Emergency Medicine Podcast · Core EM

Sympathetic Crashing Acute Pulmonary Edema (SCAPE)

·13 min·1 clip

For SCAPE, start with a nitroglycerin bolus of 500-1000 mcg, then infuse at 100-200 mcg/min, potentially titrating to 800 mcg/min for arterial dilation.

Host Brian Gilberti interviews senior resident Dr. Naz Sarpulaki on the emergency diagnosis and management of Sympathetic Crashing Acute Pulmonary Edema (SCAPE). They walk through a high-stakes case, clarify the pathophysiology as a maldistribution problem from sympathetic surge, and detail a stepwise treatment protocol emphasizing bedside ultrasound, non-invasive ventilation, and high-dose vasodilators over diuretics.

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