Pulmonary Embolism

Overview of Pulmonary Embolism

  • Pulmonary embolism (PE) is a serious condition that can be difficult to diagnose because its symptoms can mimic other respiratory issues (e.g., asthma or CHF).

  • During an early PE, lung sounds may be clear, which can mask the seriousness of the situation.

Definition of Pulmonary Embolism

  • PE occurs when a vessel supplying blood to the lungs is blocked, leading to a lack of blood flow in the lung tissues.

  • It is referred to as a "lung attack" because the lung tissues are effectively "dying" due to insufficient blood supply.

  • PE can be caused by a blockage or clot in the pulmonary arteries (thrombosis).

Comparison with Other Conditions

  • Heart Attack: Result of a blockage in coronary arteries leading to insufficient blood flow to the heart muscle.

  • Stroke: Blockage or rupture affecting blood flow to the brain.

  • Pulmonary Embolism: Blockage affecting blood flow to the lungs.

Risk Factors for Pulmonary Embolism

  • Certain factors increase the likelihood of developing PE:

    • Cancer

    • Smoking

    • Prolonged periods of immobility (e.g., long flights, bus rides, car rides)

    • Birth control usage and pregnancy

    • Recent vascular surgeries

Signs and Symptoms of Pulmonary Embolism

  • Common symptoms include:

    • Shortness of breath

    • Chest pain

    • Possible clear lung sounds or, in later stages, diminished lung sounds.

    • Elevated heart rate (tachycardia) typically ranging from 120 to 140 bpm.

    • Low oxygen saturation (SpO2), often below 94%.

  • Pay attention to the patient's history for risk factors during assessment.

Diagnosis and Treatment

  • Diagnosis:

    • Important to recognize the hallmark signs: clear lung sounds combined with chest pain and difficulty breathing.

  • Treatment Plan:

    1. Ensure high-flow oxygen to maintain SpO2 of 94-99%.

    2. Rapid transport of patient to a medical facility.

    3. If possible, transmit a 12-lead EKG to the hospital prior to arrival.

Final Considerations

  • Paramedics and EMTs have limited intervention capabilities for PE. Focus on IV administration and transport.

  • Be vigilant for young individuals, particularly heavy smokers, as PE can occur even in those as young as their twenties to forties.

  • In the hospital, treatment may include administration of heparin and other measures to dissolve clots.

  • Remember that a pulmonary embolism is a critical condition that can lead to cardiac arrest, needing immediate and effective action.