DVT complete diagnostic approach resident survival guide: Difference between revisions
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{{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 | 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 | F03 | | F04 | | F05 | | F06 | | | F03= YES| F04= NO| F05= YES| F06= NO}} | {{familytree | F03 | | F04 | | F05 | | F06 | | | F03= YES| F04= NO| F05= YES| F06= NO}} | ||
{{familytree | | | | | | | | | |!| | | |!| }} | {{familytree | |!| | | |!| | | |!| | | |!| }} | ||
{{familytree | | | | | | | | | G01 | {{familytree | G01 | | G02 | | G03 | | G04 | | G01= Surgical pulmonary embolectomy <br> OR <br> Percutaneous catheter embolectomy|G02= Continue with the same treatment| G03= '''Is there any contraindication for fibrinolytic therapy?'''| G04= Continue with the same treatment}} | ||
{{familytree | | | | | | | |,|-|^|-|.| | | }} | {{familytree | | | | | | | |,|-|^|-|.| | | }} | ||
{{familytree | | | | | | | H01 | | H02 | | H01= NO| H02= YES}} | {{familytree | | | | | | | H01 | | H02 | | H01= NO| H02= YES}} |
Revision as of 17:21, 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 | ||||||||||||||||||||||||||||||||||||||||||||||
Surgical pulmonary embolectomy OR Percutaneous catheter embolectomy | Continue with the same treatment | Is there any contraindication for fibrinolytic therapy? | Continue with the same treatment | ||||||||||||||||||||||||||||||||||||||||||||||
NO | YES | ||||||||||||||||||||||||||||||||||||||||||||||||
Fibrinolytic therapy | Surgical pulmonary embolectomy OR Percutaneous catheter embolectomy | ||||||||||||||||||||||||||||||||||||||||||||||||