<![CDATA[Background: Structured clinical decision-making is essential in the emergency management of cardiogenic pulmonary edema, yet practical application of frameworks like the SAHAR model remains unreported. Objective: This case study describes the application of the SAHAR model in emergency nursing care for an elderly patient with cardiogenic pulmonary edema. Methods: A qualitative case study was conducted at an emergency department in Indonesia. Data were collected through patient assessment, nursing intervention, and outcome evaluation. The nursing process was analyzed using the six SAHAR themes. Results: The patient presented with chest pain, severe dyspnea, hypertension, tachypnea, hypoxemia, bilateral crackles, jugular vein distention, and peripheral edema. The SAHAR model guided the nurse to prioritize airway, breathing, and circulation; implement semi-Fowler positioning, oxygen therapy, furosemide, ISDN, and fluid monitoring; and achieve clinical improvement within the evaluation period. Discussion: The structured decision-making process enabled rapid recognition of cardiogenic pulmonary edema, appropriate prioritization of life-threatening conditions, and timely evidence-based interventions aligned with pathophysiology. The SAHAR model provides a practical framework for emergency nursing in cardiogenic pulmonary edema. Further multicenter studies are warranted]]>
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