Pulmonary Embolism

http://www.nhlbi.nih.gov/health/dci/...e/pe_what.html

Not knowing is not the problem, knowing how to find the answer is the thing. The internet is rich in information there for the picking! Hope this helps

I don't think PE will show up on a chest xray that is why we order a spiral ct or vq scan.

It is usually diagnosed by symptoms and past medical history. TEE (transesophogeal echocardiogram) may show clots in the Pulmonary artery. Surgery is the only definitive treatment in this true emergency. PE has a high death rate.

Just had a pt. diagnosed with bilateral PE's at the last hour of my shift yesterday after she got her CT scan done. The doctor made me order STAT labs for a PT INR, PTT, and hypercoaguability profile. As well as ordering venous and arterial dopplers. Then ordered to start a Heparin drip with an initial Heparin bolus of 2500 units and to follow the Rashke scale and start the drip at 800 units (100 units/ml) so it starts at 8 ml/hr. I didn't actually start it because it was time to go home, but I got the ball rolling and by the time my relief came in the Heparin bag came from the pharmacy and my labs were sent and In Progress.

I was happy to make the doctor aware in the morning that the pt. was not doing well with her oxygen levels and was very decreased. Her O2 levels were 86-88% on RA after being off of 2 liters NC O2 for a while. Pt wasn't even complaining of SOB because she was so involved with her intractable pain on her right side of the body. I suggested a consult with Respiratory and the doctor took my advice and ordered that CT and the respiratory doctor came in and ordered even more tests. The pt. was there for a while and they thought she was just complaining about her pain, but there was apparently other issues brewing. It is nice to know some doctors acutually listen to you when you are concerned about a pt.

a d-dimer and v/q scan with a cxr are some ways they use to diagnose