DVT complete diagnostic approach resident survival guide: Difference between revisions
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{{familytree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D01= NO| D02= YES| D03= NO|D04= YES| D05= NO| D06= YES}} | {{familytree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D01= NO| D02= YES| D03= NO|D04= YES| D05= NO| D06= YES}} | ||
{{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | }} | {{familytree | |!| | | |!| | | |!| | | |!| | | |!| | | |!| | | }} | ||
{{familytree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E01= Fibrinolytic therapy| E02= Surgical pulmonary embolectomy <br> OR <br> Percutaneous catheter embolectomy| E03= Anticoagulation therapy <br> AND <br> | {{familytree | E01 | | E02 | | E03 | | E04 | | E05 | | E06 | | E01= Fibrinolytic therapy| E02= Surgical pulmonary embolectomy <br> OR <br> Percutaneous catheter embolectomy| E03= Anticoagulation therapy <br> AND <br> Hospital admission|E04= IVC filter <br> AND <br>Hospital admission| E05= Anticoagulation therapy<br> AND <br> Early discharge/home treatment| E06= IVC filter <br> AND <br> Early discharge/home treatment}} | ||
{{familytree | | | | | | | | | | |!| |!| | | | }} | {{familytree | |!| | | | | | | | |!| |!| | | | }} | ||
{{familytree | | | | | | | | | | | | {{familytree | F01 | | | | | | | | F02 | | | | F01= '''Does the patient fail to improve''' <br> OR <br> '''Develop cardiogenic shock?'''<br> OR <br> '''Develop hypotension?'''| F02= '''Does the patient fail to improve''' <br> OR <br> '''Develop cardiogenic shock?'''<br> OR <br> '''Develop hypotension?'''}} | ||
{{familytree | | | | | | | | | |,|-|^|-|.| | | | }} | {{familytree | |^| | | | | | | |,|-|^|-|.| | | | }} | ||
{{familytree | | | | | | | | | {{familytree | F03 | | F04 | | F05 | | F06 | | | F03= YES| F04= NO| F05= YES| F06= NO}} | ||
{{familytree | | | | | | | | | |!| | | |!| }} | {{familytree | | | | | | | | | |!| | | |!| }} | ||
{{familytree | | | | | | | | | G01 | | G02 | | G01= '''Is there any contraindication for fibrinolytic therapy?'''| G02= Continue with the same treatment}} | {{familytree | | | | | | | | | G01 | | G02 | | G01= '''Is there any contraindication for fibrinolytic therapy?'''| G02= Continue with the same treatment}} | ||
Revision as of 17:18, 9 May 2014
| Assess the severity of pulmonary embolism | |||||||||||||||||||||||||||||||||||||||||||||||||
| High Cardiogenic shock OR Persistent hypotension (≤90mmHg) OR Drop of the blood pressure by ≥ 40mmHg for > 15 min | Intermediate Right ventricular dysfunction AND/OR Myocardial injury (Troponin +) | Low No shock AND No hypotension AND No right ventricular dysfunction AND No myocardial injury (Troponin -) | |||||||||||||||||||||||||||||||||||||||||||||||
| Is there any contraindication for fibrinolytic therapy? | Is there any contraindication for anticoagulation therapy? | Is there any contraindication for anticoagulation therapy? | |||||||||||||||||||||||||||||||||||||||||||||||
| NO | YES | NO | YES | NO | YES | ||||||||||||||||||||||||||||||||||||||||||||
| Fibrinolytic therapy | Surgical pulmonary embolectomy OR Percutaneous catheter embolectomy | Anticoagulation therapy AND Hospital admission | IVC filter AND Hospital admission | Anticoagulation therapy AND Early discharge/home treatment | IVC filter AND Early discharge/home treatment | ||||||||||||||||||||||||||||||||||||||||||||
| Does the patient fail to improve OR Develop cardiogenic shock? OR Develop hypotension? | Does the patient fail to improve OR Develop cardiogenic shock? OR Develop hypotension? | ||||||||||||||||||||||||||||||||||||||||||||||||
| YES | NO | YES | NO | ||||||||||||||||||||||||||||||||||||||||||||||
| Is there any contraindication for fibrinolytic therapy? | Continue with the same treatment | ||||||||||||||||||||||||||||||||||||||||||||||||
| NO | YES | ||||||||||||||||||||||||||||||||||||||||||||||||
| Fibrinolytic therapy | Surgical pulmonary embolectomy OR Percutaneous catheter embolectomy | ||||||||||||||||||||||||||||||||||||||||||||||||