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12 Cards in this Set
- Front
- Back
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PE Severity index score <65
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low chance of mortality in 30 days
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if you walk in and see a pt with PE sx and no contraindications, what should you do right away
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shot of LMW Heparin
not totally clear if there is benefit from this but medical legal you should |
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Massive PE=
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systolic hypotension <90 for more than 15 min
must give lysing treatment |
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Right heart strain signs?
(can be seen in submassive PE) |
elevated trop
BNP >900 echo showing RV dysfunction |
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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
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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) |
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high pretest probability + decent but not perfect CT scan for PE, what should you do?
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US their legs for DVT
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if you have a low pretest probability what can you reasonably change the threshold for a positive test for d-dimer
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2x
so 1000 use WELLS for your pretest prob (if less than or equal to 4) |
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cutoff to scan a pt based on d-dimer
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500
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WELLS score less than or equal to 4 what should your d-dimer cut off be for a CT
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1000
(2x lower limit) |
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PERC Criteria?
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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? |
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If a pt had HR of 108 at check in and now has HR of 80 in the room. Can you PERC them out
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NO
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