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12 Cards in this Set

  • Front
  • Back
PE Severity index score <65
low chance of mortality in 30 days
if you walk in and see a pt with PE sx and no contraindications, what should you do right away
shot of LMW Heparin

not totally clear if there is benefit from this but medical legal you should
Massive PE=
systolic hypotension <90 for more than 15 min

must give lysing treatment
Right heart strain signs?

(can be seen in submassive PE)
elevated trop

BNP >900

echo showing RV dysfunction
what is the agent/dosage for lysis of clot in PE?

this should be considered in pts with submassive PE who would greatly benefit from having their RV strain reduced to a more baseline status
100mg Altiplase
Tx for

little PEs

Massive PEs

Submassive PEs
Heparin for little PEs in pts that look good

Thrombolytics for massive PEs

Submassive PE: RV dysfunction, consider thrombolytics (especially for young and healthy, risk of intracranial bleed rate is lower)
high pretest probability + decent but not perfect CT scan for PE, what should you do?
US their legs for DVT
if you have a low pretest probability what can you reasonably change the threshold for a positive test for d-dimer

so 1000

use WELLS for your pretest prob (if less than or equal to 4)
cutoff to scan a pt based on d-dimer
WELLS score less than or equal to 4 what should your d-dimer cut off be for a CT

(2x lower limit)
PERC Criteria?
Age < 50?
HR < 100?
O2 Sat on Room Air >94%?
No Prior History of DVT/PE?
No Recent Trauma or Surgery?
No Hemoptysis?
No Exogenous Estrogen?
No Clinical Signs Suggesting DVT?
If a pt had HR of 108 at check in and now has HR of 80 in the room. Can you PERC them out