Scenario 9 - PE

Question 1

How does PE affect HR, BP, SaO2 and JVP

Answer 1

BP: normal
HR: tachycardic
SaO2: low
JVP: may be raised in large PE

Question 2

Recall the management of PE

Answer 2

1. Oxygen
2. LMWH (tinzaparin, dalteparin)
3. Thrombolyse - but ONLY if haemodynamically unstable

Question 3

Why can warfarin not be given immediately in PE?

Answer 3

It has an initially procoagulant effect

Question 4

How do you determine whether there is axis deviation (either way) from an ECG, Amir Sam’s way?

Answer 4

Look at leads I and II - if the QRS complexes are overall negative then there is deviation

Question 5

How can you differentiate between right axis deviation and left axis deviation on ECG, Amir Sam’s way?

Answer 5

Look at aVL:
If it is pos = LAD
If it is neg = RAD

Question 6

What mnemonic should be used to identify bundle branch block on ECG?

Answer 6

WILLIAM MARROW
LBBB: W in V1, M in V6
RBBB: M in V1, W in V6