DVT and Pulmonary embolism Flashcards
_____ is a common condition caused by the formation of venous clots
DVT
what is Virchow’s triad
(a) Venous stasis
(b) Hypercoagulable state
(c) Injury to vessel wall
Most common life threatening consequence of DVT is what
Pulmonary Embolism
Most common life threatening consequence of DVT is what
Pulmonary Embolism
These factors put you at risk for what?
a) Trauma, Travel
(b) Hypercoagulable, Hormones
(c) Recreational IV drugs
(d) Age > 60
(e) Malignancy
(f) Birth control
(g) Obesity, Obstetrics
(h) Surgery, Smoking
(i) Immobilization
(j) Sickness
THROMBOSIS
What are some Symptoms of DVT
Pain, redness, swelling, warmth, and tenderness.
True/False
During the PE you don’t need to measure leg circumference and compare to unaffected leg.
False….
Measure dat shit
If unilateral leg swelling then you MUST rule out DVT, if you cant what do you do?
transfer to somewhere that can.
What are some DDx for DVT
(1) Peripheral edema
(2) Varicose veins
(3) Cellulitis
(4) Thrombophlebitis
(5) Peripheral arterial disease affecting opposite leg
Labs/Studies to order for DVT
D-dimer
Ultrasound
All patients with signs or symptoms of DVT need to
undergo an what study?
Ultrasound
WHAT IS… one of the protein fragments produced when a blood clot gets dissolved in the body. It is normally undetectable or detectable at a very low level unless the body is forming and breaking
down blood clots.
D-dimer
what is the primary goal in treating DVT
Prevention of PE
What Meds are you going to treat DVT with?
Aggressive anticoagulation -Lovenox 1mg/kg SC q 12 hours or -Heparin: 80 units/kg IV loading dose, then initiate continuous infusion 18 units/kg/hr Pain control Tylenol, Morphine
DVT Pt’s will need long term anticoagulation for how long
3-6 Months min
Initial Care for DVT
ABCs, IV, O2, Monitor
IF you suspect this then anticoagulate right away and MEDEVAC
Complications for DVT
PE
Death
If a pulmonary embolism is large enough and lodges in the main pulmonary artery or at the branch point of the left and right main pulmonary artery then this causes what cascade of events
this enormous pressure back up to the RV
the RV goes into failure
then the patient becomes hypotensive
then cardiac arrests.
What is a PE
clot that travels and lodges into a pulmonary artery.
usually from the LE veins
PE is a common and potentially fatal complication of what issue
DVT
Risk factors for PE are
Virchow’s Triad
Stasis
hypercoagulability
injury to vessel wall
True/False
PE can be very easy to make a clinical diagnosis
FALSE
It is VERY difficult to Dx in a clinical setting
What are the S/s for PE
Chest pain, tachypnea, and tachycardia.
Hypoxemia
SOB
Signs of DVT
Your pt has:
Chest pain, tachypnea, and tachycardia, SOB, Signs of DVT you must consider it to be what?
PE until proven otherwise and treated as such.
What are some DDx for PE
(1) AMI
(2) Pneumonia
(3) OSA
(4) Pulmonary HTN
(5) Anxiety
(6) Infection
(7) Pericarditis
(8) Pericardial effusion/Tamponade
(9) COPD
(10) Asthma
CXR for a PE will show up as what?
Normal…
Labs/Studies/EKG to order for PE
- CXR
- EKG: Sinus Tachycardia; non-specific ST and T wave changes
- Helical CT pulmonary angiography is the imaging study of choice
- Ultrasonography of extremities to look for DVT
What is the Goal whan treating PE
prevent further PE propagation or further clot burden due to DVT
What type of med tx would you use for PE
Aggressive anticoagulation
-Lovenox 1mg/kg SC q 12 hours
or
-Heparin: 80 units/kg IV loading dose, then initiate continuous infusion 18 units/kg/hr
Initial Care for PE
(1) ABCs, IV, O2 if saturation < 94%.
(2) Anticoagulated
(3) MEDEVAC
What are the complications of PE
(1) Pulmonary HTN
(2) RV failure
(3) Cardiac Arrest
(4) Death
