Pulmonary Embolism Snapshot

AKA: Lung clot, PE

SYMPTOMS: Shortness of air, dyspnea, chest pain, potential leg pain (if DVT first), chest tightness, anxiety, coughing (sometime with blood), diaphoretic

PHYSICAL EXAM: Tachypnea, tachycardia, hypotension, cyanosis, low 02 saturation

RISK FACTORS: Current DVT, PE or DVT history, Long period best rest, Recent long travel (road trip, plane), family history, clotting disorder (Factor V Leiden), malignancy, birth control, estrogen, smoking, recent surgery, implantable devices, obesity

LABS & TESTS: May consider EKG, Cardiac enzymes, CXR, BNP, ABGs, etc., first depending upon the situation, in order to r/o other causes. More specific tests, if PE specifically suspected, are: D-dimer, CT of chest with contrast (important with contrast), VQ scan if can’t do CT due to renal function (contrast). Will also want to get PT/INR monitoring especially if placed on heparin drip (protocol) and or warfarin.

MEDICATIONS EMERGENT: Lovenox therapeutic dose or the drip below

DRIPS: Heparin (Heparin drip vs SQ Lovenox- usually one or the other)

PROCEEDURES: Inferior vena cava filter (aka: Green filter) (if recurrent and or anticoagulants are contraindicated)

CHRONIC MEDICATIONS: Anticoagulants (Ex: Warfarin)

CONSULTANTS: Pulmonology

TOOLS: Wells Score tool (Score >6 high probability)

WAYS TO PREVENT: Lovenox prophylaxis dose (in hospital, ongoing bed rest, risk to develop), compression stockings, regular physical activity

Note: This is not an all-inclusive list. This is a generalized overview list

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