Flashcards in PE Deck (18)
What is hip pinning and what complications can occur?
Hip pinning fixes a broken hip using pins, screws and plates
Comp = infection, blood clots, DVT
Why do people who have hip pinning have increased risk DVT?
Reduced movement and mobility
What is PE and how does it form?
Usually derived from fragment DVT
Fragments become detached from site and travel via venous return via RHS to pulmonary arteries
Does size of PE change clinical outcome?
Large PE can become lodged at bifurcation of pulmonary artery = sudden death
Smaller PE can become lodged in peripheral branch leading to infarction
Symptoms see w/ PE?
SOB, chest pain and sometimes cough up blood
What ECG finding see w/ PE?
Sinus tachycardia - reduced blood flow to lung cause SOB increased HR
What is heparin?
In family glycosamingoglycans
How does heparin work?
Action antithrombin III - inhibit thrombin and inactivate prothrombin
How measure effect heparin?
Kaolin-cephalin clotting time
How to reverse effect heparin?
How is heparin related PE?
Low molecular weight heparin given as immediate anticoagulation
Can be given as prophylaxis to those at risk DVT/PE - slow progression DVT
What is Well's score
Number that reflect risk of developing DVT
What is CTPA and its purpose?
CT pulmonary angiogram
Obtain imagine pulmonary arteries - diagnostic tool for PE
How is CTPA performed and contraindication?
IV injection of iodine-containing contrast agent (dark mass can show embolism)
1. Pregnancy - concern effect thyroid gland foetus
2. Renal disease - risk contrast induced nephropahy
Why is renal function test needed before CTPA?
Contraindicated in those w/ renal disease - unable to clear medium and can put at risk of nephropathy
Anticoagulation therapy for someone w/ PE?
Immediate anticoagulation injection for at least 5 days (usually heparin)
Managed as outpatient using warfarin - at least 3 months
Explain heparin dose in hospital setting
IV heparin every 4-6 hours
Heparin administered at provisional diagnosis - if hospital dose given at 6, amount worked out as top up dose