Pulmonary EmbolismPulmonary Embolism

Natalie Bermudez, RN, BSN, MSNatalie Bermudez, RN, BSN, MSClinical Educator for TelemetryClinical Educator for Telemetry

Telemetry Course

Pulmonary EmbolismPulmonary EmbolismStatisticsStatistics

Occurs in more than 600,000 patients annually in the U.S.

Contributes to 50,000 to 200,000 deaths per year

Two-thirds of patients with fatal cases will die within one hour of

presentation

(Woods et al, 2005, p.166)

Pulmonary EmbolismPulmonary EmbolismStatisticsStatistics

The mortality rate for hospitalized patients with

PE has remained at approximately 15% over the

past 40 years.

(Woods et al, 2005, p.166)

An obstruction of the pulmonary artery or

one o f its branches by a thrombus (or

thrombi) that originates in the venous

system or the right side of the heart.

Pulmonary EmbolismPulmonary Embolism

Most common thromboembolic problem in patients with

heart failure

Also caused by fat, air, amniotic fluid or septic emboli

Pulmonary EmbolismPulmonary Embolism

Risk Factors:Risk Factors:

DVT Atrial Fibrillation

CAD CHF

Hemostasis

Pulmonary EmbolismPulmonary Embolism

Risk Factors:Risk Factors:

Postpartum Postoperative

Oral Contraceptives

Obesity

SIGNS & SYMPTOMS:SIGNS & SYMPTOMS:

Pulmonary EmbolismPulmonary Embolism

Dyspnea Chest Pain Hemoptysis Tachycardia Hypoxia

Anxiety Fever Cough Diaphoresis S/S of DVT

Diagnostic EvaluationDiagnostic EvaluationPulmonary EmbolismPulmonary Embolism

Chest x-ray

DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:

CT Angiogram of Chest V/Q Scan D-dimer ABG’s

Peripheral Vascular Studies (etiology) EKG (etiology)

Pulmonary EmbolismPulmonary Embolism

DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:

D-dimerD-dimer

It is a fibrin degradation fragment

Occurs through fibrinolysis

Pulmonary EmbolismPulmonary Embolism

DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:

V/Q ScanV/Q Scan

Ventilation & Perfusion Scan

2-part Test

Pulmonary EmbolismPulmonary Embolism

TREATMENT OF TREATMENT OF SYMPTOMS:SYMPTOMS:

Analgesics

Supplemental O2 Therapy

Pulmonary EmbolismPulmonary Embolism

MEDICAL MANAGEMENT:MEDICAL MANAGEMENT:

Anticoagulant Therapy Thrombolytic Therapy

Bedrest Surgical Embolectomy

Pulmonary EmbolismPulmonary Embolism

ReferencesReferencesHodgson, B. B., & Kizior, R. J. (2007). Saunders nursing

drug handbook. St. Louis, MS: Saunders Elsevier.

Skidmore-Roth, L. et al. (2007). Mosby’s nursing drug reference, (20th ed.). St. Louis, MS: Mosby Elsevier.

Smeltzer et al. (2008). Brunner and suddarth’s textbook of medical-surgical nursing, (11th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.

Woods, S. L., Sivarajan Froelicher, E. S., Underhill Motzer, S., & Bridges, E. J. (2005). Cardiac Nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.