For my ER rotation I had a pt present with s/sx of a PE, dyspnea, SOB, pale, sweaty, pain 7/10, and decreased LOC.
upon assessment I obtained new vitals and pulse ox, full pain assessment, lung and heart sounds, ECG, chest x-ray, ABG's, UA and sputum sample to rule out possible infection. However I felt like I totally missed something.
Also, when it comes to getting a proper medical history, I obtained allergies, contraception, smoking hx, and recent trauma. Is there anything else that would be beneficial to know other then this regarding pt hx?
Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.
If it hasn't been mentioned already, cardiac enzymes (CPK, CK-MB, Troponin I) should also be run; plus, CMP, CBC, PT/ptt - since pt. will probably wind up on heparin at some point.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
no pt hx of afib, dvt or coagulopathy.
only allergy is Sulfa meds, and currently on the pill. 1 ppd smoking for 8 years, and a recent trip from Asia. I suppose the long flight might have been a precipitating factor.
It is well documented legs in the dependent position and long flights are a factor in developing PE. Add that to BCP and smoking........she's a walking PE picture! Some facilities add d-dimers to assist in R/O Pe criteria....nice job!
Recent abdominal surgery would be another risk factor.
Pt's vitals were somewhat stable upon admission, however over several hours bp dropped to as low as 88/58, and pulse, resp, temp, and pain levels all increased. O2 sats tanked from 90% to 80% while on 2l/nc. She was in sinus tachy, and began coughing bloody sputum.
Spacklehead, MSN, NP
620 Posts
If it hasn't been mentioned already, cardiac enzymes (CPK, CK-MB, Troponin I) should also be run; plus, CMP, CBC, PT/ptt - since pt. will probably wind up on heparin at some point.