Massive PE

Question 1

What is a massive PE?

Answer 1

Massive pulmonary embolism is defined as obstruction of the pulmonary arterial tree that exceeds 50% of the cross-sectional area, causing acute and severe cardiopulmonary failure from right ventricular overload.

Question 2

Meds for massive PE

Answer 2

Enoxaparin (lovenox)
Heparin (UF)
tPA (tissue plasminogen activator)

Question 3

Enoxaparin (lovenox) dose (massive PE)

Answer 3

1mg/kg SQ

Question 4

Heparin (UF) dose (massive PE)

Answer 4

80 U/kg bolus (no max)
Then
18 U/kg/kr drip

Question 5

tPA dose (massive PE)

Answer 5

100mg (10mg over 10 min then 90mg over 2 hrs)

if PE is susptected cause of cardiac arrest:
- 50mg over 2 min
- continue CPR x 15 min and repeat PRN