2-46
2-46. PULMONARY EMBOLISM
a. Pulmonary embolism is the presence of one or more thrombin that has moved from their site of origin, into the pulmonary vascular bed, to obstruct one or more of the pulmonary arteries. These thrombin originate somewhere in the venous system or the right side of the heart. They become dislodged and are carried to the lung, interrupting the blood supply to lung tissue and causing infarction of lung tissue.
b. Signs and symptoms range from nonexistant to pleuritic pain, cough, hemoptysis, tachycardia, dyspnea, and anxiety. The symptoms present will depend upon the size of the thrombus and the location of the occlusion.
c. Treatment for pulmonary embolism involves immediate measures to stabilize the patient. Massive pulmonary embolism is a life threatening medical emergency. Oxygen is administered to relieve respiratory distress. An IV is started to provide a life-line for administration of emergency medications. If the embolism is severe enough, the patient may require an indwelling urinary catheter, endotracheal intubation, mechanical ventilation, and ECG monitoring. The second aspect of treatment involves anticoagulant therapy to prevent recurrence or extension of the embolism. This therapy is potentially dangerous and must be strictly controlled by the physician.
