Step 2

Question 1

factors involved in the risk stratification of PE

Answer 1

risk stratification is used to determine a patients risk of haemodynamic collapse and therefore may require additional interventions to anticoagulation

High risk;
- hypotension or shock; BP <90 (or drop >40 from baseline) sustained over 15 min period = systemic thrombolysis for these patients

Intermediate high risk
- signs of RV strain as evident by BNP, troponin, ECG changes and echo (RV dilatation or dysfunction) = anticoagulation but if pronounced findings of RV strain then catheter directed thrombolysis or aspiration thrombectomy may be considered

Low risk
- none of the above = start anticoagulation alone

Question 2

mainstay of management of fat embolism

Answer 2

oxygen supplementation via nasal cannula
IV fluids
vasopressors as needed