CuraRN

Pulmonary Embolism

Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.

EMS etiologies

Setting: ER

Pulmonary embolism (PE) is typically caused by a blood clot that originates from deep vein thrombosis (DVT) in the lower extremities and travels to the lungs. The risk factors for PE are closely related to those for DVT and are explained by Virchow’s triad, which includes hypercoagulability, venous stasis, and endothelial injury. PE risk factors can be genetic or acquired (e.g., immobilization, surgery, cancer, obesity, and use of oral contraceptives).

PE occurs when these clots obstruct the pulmonary arteries, leading to impaired gas exchange and strain on the right side of the heart.

PE can be classified into:

• Hemodynamically unstable PE (high-risk), leading to low blood pressure, right ventricular failure, and shock.
• Hemodynamically stable PE, ranging from mild symptoms to significant respiratory issues but without severe circulatory compromise.

Clinical Presentation:

Symptoms of PE include sudden shortness of breath, pleuritic chest pain, cough, hemoptysis, and, in severe cases, syncope or shock. Early diagnosis and treatment are critical, as untreated PE has a high mortality rate.

Treatment Modalities:

• Anticoagulants
• Thrombolytic therapy
• Surgical removal of clots (embolectomy)
• Inferior vena cava filter (prevention)

Treatment involves anticoagulation (heparin, LMWH, or NOACs), thrombolysis, or, in severe cases, surgical embolectomy. In certain cases, vena cava filters may be used to prevent further emboli.