SandBox
|
Pulmonary Embolism Microchapters |
|
Diagnosis |
|---|
|
Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
|
Treatment |
|
Follow-Up |
|
Special Scenario |
|
Trials |
|
Case Studies |
|
SandBox On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Overview
Pulmonary embolism (PE) is a potentially lethal condition, with a mortality rate close to 30 percent without treatment. Thus prompt and effective therapy is utmost important. In most cases, anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia, are often required.
Treatment Algorithm
| Stabilize the patient | |||||||||||||||||||||||||||||||||||||
| Is anticoagulation contraindicated ? | |||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||
| Diagnostic evaluation | Anticoagulate with SC LMWH or IV UFH | ||||||||||||||||||||||||||||||||||||
| PE excluded | PE confirmed | Diagnostic evaluation | |||||||||||||||||||||||||||||||||||
| No further Treatment | Inferior vena cava filter | PE excluded | PE confirmed | ||||||||||||||||||||||||||||||||||
| Discontinue Anticoagulants | Clinicaly severe enough to need Thrombolysis | ||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||
| Is thrombolytic Contraindicated? | Continue Anticoagulants | ||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||
| Surgical emblectomy or catheter based interventions | Hold Anticoagulation, Give Thrombolytics then resume Anticoagulations | ||||||||||||||||||||||||||||||||||||
| Patient show Clinically Improvement | |||||||||||||||||||||||||||||||||||||
| No | Yes | ||||||||||||||||||||||||||||||||||||
| Surgical emblectomy or catheter based interventions | Continue Anticoagulation | ||||||||||||||||||||||||||||||||||||