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Pulmonary embolism (Risk factors (Leg fracture, Immobility, Clotting…

- - - - Tachycardia
      - Fever
      - Tachypnoea
      - Scattered creps
      - Pleural rub
    - - Cyanosis
      - Fever
      - Tachypnoea
      - Raised JVP
      - Hypotensive
      - Tachycardia
      - Pulmonary murmur
        (turbulent flow)
  - - - ABG
        Low O2, high CO2 if hyperventilating
      - Routine
        FBC, CRP, U+E, clotting,
        D-dimer (if low risk), troponins, amylase
    - - CT pulmonary angiogram (CTPA)
        Definitive diagnosis
      - V/Q scan
        Rarely used
      - Doppler USS leg
        First line in pregnancy
      - CXR
        May be normal
        Oligaemia of affected segment
        Dilated pulmonary artery
        Wedge-shaped opacities
        Pleural effusion (small)
        Atelectasis
    - - O2 sats
        Low
      - HR
        Tachy
      - BP
        May be hypotensive
      - ECG
        (sinus tachy, RV strain, RBBB;
        S1 Q3 T3 is raree)
      - Temp
        Low grade fever
- - - - Anticoagulation
        If stable, SC LMWH (e.g. enoxaparin)
        If unstable, IV heparin
      - Refer
        Respiratory, cardiothoracics
    - - Refer
        Urgent ITU help
      - Thrombolysis
        Alteplase (tPA)
    - - Vena cava filter