Pulmonary Embolism Flashcards
pulmonary embolism
emboli that has travelled to the pulmonary arteries
causes/risk
DVT immobilisation for a long period surgery malignancy anti-phospholipid syndrome
signs
pleuritic chest pain, sudden onset dynspnoea tachycardia haemoptysis shock right heart stress
investigations
CT thoracic, abdomen, pelvis
bloods, clotting screen, thrombophilia screen
V/Q scan - renal impairment or pregnancy
ECG signs
sinus tachycardia
right heart stress
RBBB
ABG result
type 1 resp failure
what criteria is sued
Well’s score
Well’s Score
3 points:
signs of DVT
high suspicion of PE
1.5 points:
previous DVT/PE
>100 bpm
recent surgery in past 4 weeks/period of immobilisation in past 3 days
1 point:
haemoptysis
malignancy
what does a score of 4 or less mean
do a d-dimer, if positive then arrange for a CTPA
a score of more than 4
arrange for a CTPA
what must you do if waiting for a CTPA
put patient on anticoagulants
when would you do a V/Q scan
pregnancy
renal impairment
management
DRABCDE
thrombolysis if haemodynamically unstable
anticoagulant therapy
provoked PE management
cancer diagnosis:
anticoagulant for 6 months
no cancer diagnosis:
anticoagulant for 3 months
unprovoked PE management
anticoagulant for 6 months
