Pulmonary Embolism Flashcards
(21 cards)
define PE
obstruction of the pulmonary artery or one of its branches
where do PE’s originate?
venous system
VTE Formula
DVT + PE = VTE
PE are A/W
trauma surgery pregnancy heart failure age (>50) hypercoagable states afib prolonged immobility birth birth control smoking
PE occurs when
- gas exchange is impaired or absent
- ventilation w/o perfusion
- alveolar dead space is increased
- pulmonary vasoconstriction
- incr pulmonary vascular resistance
- increased ventricular work
severity of PE depends on
- size of the obstruction
- size of the pulmonary bed is being affected
- degree of hemodynamic instability
clinical manifestations of PE
size dependant dyspnea ***tachypnea*** chest pain cough hemoptysis anxiety apprehension fever tachycardia diaphoresis
Assessment and DX of a PE
CXR ECG Pulse OX ABG VQ Scan Pulmonary Angiogram Pulmonary Spiral CT
what are the benefits of using a VQ scan
minimally invasive
what are the risks of using a VQ scan
must use contrast
what must be checked before using a VQ scan
renal system
what is the benefit of using pulmonary angiogram
quick and very accurate
what is the benefit of using a pulmonary spiral ct scan
very in depth test
why might a pulmonary spiral ct scan not be done?
very expensive- insurance may not cover
PE mgmt
- emergency mgmt: SPO2, assess if they need O2, eval response, ekg, labs
- lyse the existing emboli
- prevent a new one from forming
PE Tx
- improve resp and cardiovascular status
- anticoag/thrombolytic therapy
- surgical intervention
- IVC
what is an IVC
an umbrealla that catches clots that for over the r atrium
describe how a VQ scan works
- pt inhales radioactive compound
- inject radioactive compound into veins
- mismatch of region seen on scan
what is a VTE (Venous Thrombus Embolism)
a dvt that has moved
prevention of a dvt/vte
avoid venous stasis activity/leg exercises early mobilization anti embolic stockings scd's anti coags
name the 3 m’s
mvmt
meds
mechanical devices
