Pulmonary Embolism (PE) Lecture Notes

Overview

• Pulmonary Embolism (PE): Blockage in the pulmonary vessels, part of venous thromboembolism (VTE).
  • Venous Thromboembolism (VTE): Clots occurring in any vessel.
  • Deep Vein Thrombosis (DVT): Can lead to PE if dislodged.

Causes of PE

• Air Bubble: Accidental injection or rapid ascent during diving.
• Fat Deposits: Rare cause of PE.
• Blood Clot: Most common cause, often from dislodged DVT.

Risk Factors

• Existing DVT.
• Trauma or surgery disrupting blood flow.
• Hypercoagulable states (e.g., pregnancy, oral contraceptive use).
• Immobility (e.g., bed rest).

Diagnosis

• D-dimer Test: Elevated levels (>0.5) indicate clot presence.
• CT Scan & Chest X-ray: Visualize lungs to locate clot.

Symptoms of PE

• Shortness of breath.
• Rapid breathing.
• Increased heart rate.
• Reduced oxygen saturation.
• Chest pain.
• Anxiety, restlessness, feeling of impending doom.

Treatment

• Heparin: Administered via IV drip to prevent clot growth.
  • High alert medication, requires verification by two nurses.
• Thrombolytics: Medications to dissolve clots.
• Surgical Embolectomy: Removal of the clot if necessary.

Prevention

• TED Stockings & Compression Devices: Promote blood flow.
• Leg Exercises & Early Ambulation: Important for post-op patients.
• Lifestyle Adjustments: Stop smoking, educate on anticoagulant therapy (e.g., heparin, warfarin, lovinox).
• Long Travel Considerations: Encourage movement, leg exercises.

Key Points for Nurses

• Be attentive to symptoms, especially the sense of impending doom.
• Act quickly upon patient reports and symptoms.
• Differentiate between prevention and treatment strategies.
• Prevention: Encourage movement and blood flow.
• Treatment: Bed rest, avoid disturbing the clot.

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