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Old 06-11-2011
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Lungs Pulmonary Embolism Management; Correct me if am wrong!

Regarding the management of PE i want to mention all that i got and ill appreciate if u correct me where im wrong

We begin with an chest Xray in a pt with tachypnea and pleuritic chest pain (this is usually given in the stem to be normal) to exclude other causes.

Next best step in high risk people is heparin administration enroute to radiology dept. for V/Q scan or CT.

First test is V/Q scan
a NORMAL one excludes PE
a low intermediate or high probability asks for further investigation
which is spiral CT
in low/intermediate risk normal CT plus normal D dimers
or normal CT plus normal duplet scan excludes it
in high risk nothing but an angiogram can rule it out but enroute to angio since it's an invasive procedure we do duplex to be sure its gonna be yielding.

treatment is with Oxygen and anticoagulants except
1) hemodyanamically unstable pt who requires thrombolysis as well
2) in case of contraindication to anticoagulation where greenfield filter or embolectomy is resorted to.
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Old 06-11-2011
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thank u man
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Old 06-11-2011
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Originally Posted by amberafzal View Post
Regardin the management ov PE i wanna mention all dat i got and ill appreciate if u correct me where im wrong
we begin wid n Xray chest in a pt ov tachypnea and pleuritic chest pain(dis is usually given in d stem to be normal) to exclude other causes.
next best step in high risk people is heparin administration enroute to radiology deptt. for V/Q scan or CT.
first test is V/Q scan
.
we start with heparin and warfarin in same time
and when cxray is normal we order v/Q test
if abnormal cxray we order spiral c.t angiography
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Old 06-12-2011
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u sure we start wid warfarin at d same tym before investigations r complete? n in case ov an Xray suggestive ov PE, its CT to be done next n nt v/q?
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Originally Posted by amberafzal View Post
u sure we start wid warfarin at d same tym before investigations r complete? n in case ov an Xray suggestive ov PE, its CT to be done next n nt v/q?
yes from mtb page 162
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