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Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary Embolism III: Nursing Management01:27

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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Venous Thrombosis III: Interprofessional Care01:29

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
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High-Risk Pulmonary Embolism: Current Evidence-Based Practices.

Christopher D Theroux1, Jason M Aliotta2, Christopher J Mullin2

  • 1Department of Medicine, Alpert Medical School of Brown University.

Rhode Island Medical Journal (2013)
|December 5, 2019
PubMed
Summary
This summary is machine-generated.

Acute pulmonary embolism (PE) poses risks, especially with right ventricular (RV) dysfunction. Risk stratification guides treatment, including reperfusion therapies like thrombolysis for high-risk PE patients.

Keywords:
catheter-directed thrombolysispulmonary embolismsystemic thrombolysis

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Area of Science:

  • Cardiology
  • Pulmonology
  • Vascular Medicine

Background:

  • Acute pulmonary embolism (PE) is a leading cause of morbidity and mortality.
  • Right ventricular (RV) dysfunction is a critical factor in PE prognosis.
  • Accurate risk stratification is essential for guiding PE treatment decisions.

Purpose of the Study:

  • To review the current understanding of risk stratification in acute pulmonary embolism.
  • To discuss the role and controversies surrounding reperfusion therapies in intermediate and high-risk PE.
  • To highlight the need for further research into advanced reperfusion strategies.

Main Methods:

  • Literature review of current guidelines and studies on PE management.
  • Analysis of risk stratification tools focusing on RV function.
  • Evaluation of different reperfusion strategies: systemic thrombolysis, catheter-directed thrombolysis (CDT), and embolectomy.

Main Results:

  • High-risk PE patients generally benefit from reperfusion therapy, primarily systemic thrombolysis.
  • The use of reperfusion therapies in intermediate-risk PE remains controversial.
  • Catheter-directed thrombolysis (CDT) may be considered for select intermediate-risk patients, but lacks robust comparative data.
  • Surgical or catheter embolectomy are alternatives for high-risk patients with contraindications to thrombolysis.

Conclusions:

  • Risk stratification, particularly RV function assessment, is crucial for managing acute PE.
  • Systemic thrombolysis is recommended for high-risk PE.
  • Further research is needed to define the optimal use of advanced reperfusion therapies, including CDT, in intermediate-risk PE patients.