1、Pulmonary EmbolismnPathophysiology Pulmonary artery blocked Blood:Does not pass alveoliDoes not exchange gasesCausesnBlood clots=most common causenVirchows Triad Venous stasis bed rest,immobility,casts,CHF Thrombophlebitis vessel wall damage Hypercoagulability Birth control pills,especially with smo
2、kingCausesnAirnAmniotic fluidnFat particles Long bone fracture more quickly splinted,less chance of fat embolinParticulates from substance abuseSigns/SymptomsnSmall Emboli Dyspnea Tachycardia TachypneaSigns/SymptomsnLarger Emboli Respiratory difficulty Pleuritic pain Pleural rub Coughing Hemoptysis
3、Localized WheezingSigns/SymptomsnVery Large Emboli Respiratory distress Central chest pain Distended neck veins Acute right heart failure Shock Cardiac arrestSigns/SymptomsThere are NO findings specific to pulmonary embolismManagementnAirway Consider intubation early(if does not cause delay)nBreathi
4、ng 100%O2 NRB mask Consider assisting ventilations(if not intubated)nCirculation IV x 2,lg bore,NS,TKO May attempt fluid bolus if hypotensive or shock ECG monitornRapid transport thrombolysis or pulmonectomy may be usefulPulmonary EmbolismIf the patient is alive when you get to them,that embolus isnt going to kill them,BUT THE NEXT ONE THEY THROW MIGHT!
