Lecture Notes: Pulmonary Embolism (PE)

Introduction

• Presenter: Christine from Nurse in the Making
• Topic: Pulmonary Embolism (PE)
• Reference: Med Surg Flash Cards, Cardiovascular Section

Understanding Pulmonary Embolism (PE)

• PE Definition: Blockage in the pulmonary vessels, preventing gas exchange.
• VTE (Venous Thromboembolism):
  • Includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
  • Clots can occur in any vessel.
  • DVT can transition into a PE if the clot travels to the lungs.
• Other Causes of PE:
  • Air bubble in the bloodstream (e.g., from syringe injection or diving).
  • Rarely, small fat deposits.

Risk Factors for PE

• Primary Risk: Existing DVT.
• Other Risk Factors:
  • Trauma or surgery.
  • Hypercoagulable states (e.g., pregnancy, contraceptive use).
  • Immobility (e.g., bed rest).

Diagnosing PE

• D-Dimer Test:
  • Detects protein fragments from clots.
  • Elevated levels (>0.5) indicate potential clot.
• Further Testing:
  • CT Scan and Chest X-ray to locate the clot.

Symptoms of PE

• Shortness of breath.
• Rapid breathing.
• Increased heart rate.
• Decreased oxygen saturation.
• Chest pain, anxiety, restlessness.
• Feeling of impending doom (take seriously).

Treatment of PE

• Immediate Action: Heparin IV drip to prevent clot growth.
  • Nursing Tip: High alert medication, requires verification by two nurses.
• Other Treatment Options:
  • Thrombolytics to dissolve clots.
  • Surgical intervention (embolectomy) if necessary.
• Prevention Measures:
  • Use of TED stockings and compression devices.
  • Leg exercises and early ambulation post-operation.
  • Avoid smoking.
  • Educate on anticoagulant therapy (Heparin, Warfarin, Lovanox).

Prevention vs Treatment

• Prevention: Encourage movement and blood flow.
• Treatment:
  • Bed rest to prevent clot migration.
  • Avoid massaging or applying heat to the affected area.

Conclusion

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