Pulmonary embolism question

[Lucyinthesky]

Hi, we were discussing PE's in class and what to do if you suspect one. of course after all the usual answers the prof asked us which side do you want to lay them on (left or right)? Nobody in the class knew and she wants us to research it. I have been able to find nothing definitive on this question. FYI this is not for a grade. any help would be appreciated.

[CHATSDALE]

HOB up...aids in respiration...do not want to strugle for breath..i had one in left lung and they put me up...after they missed the sx...but i survived

[Lucyinthesky]

"HOB up...aids in respiration...do not want to strugle for breath..i had one in left lung and they put me up...after they missed the sx...but i survived"

Thanks for the reply Chatsdale. What I am looking for though is specifically what side do you have them lay on (left or right)? I'm not really sure why that would matter except if it has something to do with blood flow.

[truern]

Left side down-trendelenberg position might trap the embolus in the right ventricle and prevent migration to the lung.

SUSPECTED AIR EMBOLISM

Turn patient left side down, trendelenberg position (head down). If possible, ask patient to perform valsalva maneuver. Administer 100% oxygen. If the patient has a right atrial or pulmonary artery catheter, attempt to aspirate air

http://www.lhsc.on.ca/critcare/ucicu/procs/cvpremov.htm

[EricJRN, MSN, RN]

I think it's a little bit of a trick question. If you introduce air into the patient's circulation and are trying to prevent air embolism, left lateral Trendelenberg would be just the thing. In PE though, you already have migration of the embolus to the lung or pulmonary vasculature, so I'm not sure that position would be any help.

Since your patient is likely to be acutely short of breath, I would go with semi-Fowler's or some sort of HOB up position.

[NRSKarenRN, BSN, RN]

positioning the patient in the left lateral decubitus position will help to keep air in the right atrium from entering the ventricle..

http://www.rashaduniversity.com/venairem.html

had to do this few times in my career

good article:

pulmonary embolism (pe): lung and airway disorders: merck manual ...

[S.N. Visit, BSN, RN]

Thank you for posting this question, it's exactly what we are studying right now. I will remember the answer to this one!

[Lucyinthesky]

Thanks for the info! I have class tonight and will see if this was what she was referring to.

[kgkarma]

Thanks for the info! I have class tonight and will see if this was what she was referring to.

I have an exam on the respiratory system on Monday and am looking for some practice exams. This stuff is driving me crazy. Just can't seem to get my hands around it. The power points are no help at all. :angryfire