Pulmonary Embolism (PE) Flashcards
What is a Pulmonary Embolism?
- The blockage of 1 or more pulmonary arteries by a thrombus, fat or air embolus, or tumor tissue.
What are emboli?
Mobile clots that generally do not stop moving until they lodge at a narrowed part of the circulatory system
- Mobile clots that generally do not stop moving until they lodge at a narrowed part of the circulatory system
Most PE’s arise from what?
DVT (deep vein thrombosis)
What are some lower limb sites of origin for emboli to form and travel to the pulmonary system?
- Femoral or iliac veins,
- Right side of the heart (atrial fibrillation), and
- Pelvic veins (especially after surgery or childbirth)
What are some reasons that may cause DVTs develop in the upper extremity?
- Presence of central venous catheters or arterial lines.
- These cases may resolve with the removal of the catheter.
Why are pulmonary emboli so difficult to diagnose?
The s/s are quite general and hard don’t point to a PE until they become serious
What are some key indicators of a massive PE?
- Sudden change in mental status
- Sudden SOB onset
- Hypotension
- Feelings of impending doom
True or false
Most PTs w/ massive PE’s die w/in the first hour
- False
- 10% die in first hour
Treatment with _____ significantly reduces PE mortality.
Anticoags
What is the main complication of PE?
Pulmonary infarction
What is pulmonary infarction?
Death of lung tissue
How does a PE cause pulmonary infarction?
When an emboli blocks a ≥ medium pulmonary vessel and there is insufficient collateral blood flow from bronchial circulation
What diagnostics are run for PE?
- D-dimer – looking for elevated fibrin fragments (not reliable for small Pes)
- CT scan – w/ contrast media
- V/Q scan if PT can’t do have contrast media
Upon dx of PE, immediate assessment should focus on the patient’s _____ _____, which can vary according to the size and location of the PE.
cardiopulmonary status
O2 should be given by mask or cannula when _____ is present.
Hypoxemia
