patient death from PE

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I recently lost a 20 something patient in the ED and other nurses say it was probably a PE. I keep going over everything in my mind and questioning what we did. If you have had a patient die from a PE will you share your experience for comparison?

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"It was a PE" is a eupemism for what the $%$?

It is used way too frequently when the cause of death has not been defined.

A pulmonary embolus has a root cause. Was she on birth control, recently traveled via air...etc.

Analyze her death and learn from it.

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Specializes in Nurse Scientist-Research.

I kind of used to think the PE thing was just an easy go-to diagnosis the doc could throw out there and it probably is. But when I would watch "Dr. G. Medical Examiner" she used to find quite a few in those patients with unexplained death.

Usually there is a root cause for a PE, but sometimes it's difficult to find. Smoking and birth control: very bad. Obesity! How much of that are we seeing nowadays.

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Specializes in ED/ICU/TELEMETRY/LTC.

Had a 21 year old, had an appendectomy. Went home. Came back in the next night, very dead. PE's happen for a lot of reasons. A little clots gets loose and there you go. So sad.

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had one once in a 13-year-old. on post she was found to have an occult malignancy in her pancreas (big risk factor for thrombosis). weird, and so sad.

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Specializes in Emergency, Haematology/Oncology.

Oh dude,

I don't know if this helps but in several years I have only had 4 patients who were young that suddenly just died on me. Only one survived and all of them had PE's. We had a thirty year old lady who had been admitted under medicine for a DVT, there were no beds so she was still in the ED, only symptom was a sore leg. She had a syncopal episode on the commode in the early hours of the morning and I asked her how she was feeling- she made a little joke, Ï've felt better" Unresponsive in full cardiac arrest 10 minutes later. We worked on her for an hour and a half, she later bled out in ICU. You didn't do anything wrong- and no matter how much you go over it I would have to think that she had a Ventilation/Perfusion abnormality, and realistically there is nothing you could have done. The one that survived collapsed at a resturant and arrested within ten minutes, had two prolonged arrests but fortunately recovered well- no history of CP nothing. The four H's and the four Ts. The big T, thrombus seems to attack fairly well people also, some peoples genetics simply pre-dispose them to clots. Only one of these young people had a red flag during their workup. Unfortunately, because young people compensate so well we don't realise there is something very wrong until they have their hypoxic arrest, definitive management- filters/embolectomy/thrombolysis- all need time but the patient is usually walking up the white stairs by the time we know what they need. Hope this helps.

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Specializes in Med-Surg/Oncology.

While I was still in preceptorship on my floor, we had a man who was being discharged, all papers signed, IV had been taken out, street clothes on, stood up to get into the wheelchair to be taken out to his car and collapsed, immediately unresponsive (AKA, dead). We coded and coded and coded, 45 minutes long. Didn't get him back. Autopsy revealed PE.

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thank u allactually was a male patient with no clot risk factors we knew ofhe had had a spontaneous pneumo three weeks previously and a NSTEMI however and had COPDso when he presented with tachycardia tachypnea and chest pain after ruling out another pneumo they started treating him as if he was having a COPD exacerbationAfter placing him on Bipap he started bradying down turned pale then purple and we ended up coding him without success

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how is it possible (during a code) to come up with and confirm that diagnosis soon enough to treat it?

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Specializes in LTC, Hospice, Case Management.

I hate taking my coumadin - I hate getting those stupid blood tests.

Ya'll have just convinced me to not "forget" my dose tonight. Thanks. (Previous history of 2 DVT's w/ 2 PE's...13 years apart) 3rd time could be the charm

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Specializes in Oncology, OR, Surgical, Orthopedics.

During my last assignment, I discharged an older gentleman, before his morning medications, per his family's request. (the pt didn't speak English, so the family did most of the translating. The "blue phones" didn't have anyone that spoke this language either). 2 hr's later, the ED charge nurse called me to ask about this pt's history and wgat medications had been given that morning. He was found down in his bathroom by the family. He passed. I felt horrible. He had requested to walk out to the front door, and I had walked with him. He was found on autopsy to have had a massive PE. The hospitalist and I sat down later that day and discussed the case, but there was nothing either of us would have done any differently. It was just one of those things that happens, and we as health care providers have to live with, even when we don't like it.

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I hate taking my coumadin - I hate getting those stupid blood tests.

Ya'll have just convinced me to not "forget" my dose tonight. Thanks. (Previous history of 2 DVT's w/ 2 PE's...13 years apart) 3rd time could be the charm

Why you...! ::shaking you ferociously::

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