PULMONARY

EMBOLISM

PRESENTED BY:
MISS. M.K.KAKU
NURSING TUTOR
 INTRODUCTION
 Pulmonary embolism refers to the obstruction of
one or more pulmonary arteries by thrombus
originating usually in the deep veins of the legs,
right side of the heart and rarely in upper
extremity which moves to the pulmonary
vasculature.
 Herethe blood supply and perfusion is impaired
and lead to infarction(necrosis) of lung
 ETIOLOGY & RISK FACTORS
 Prolonged immobilization
o Surgery
o Fracture and trauma in leg or arms
 Prolonged bed rest
 Due to pregnancy because of high level of estrogen
 Coagulation disorders
 Polycythemia (Too many RBC in blood)
 Phlebitis ( Inflammation or injury to vessel wall)
 After delivery
 PATHOPHYSIOLOGY
Obstruction of pulmonary artries

Causes
Increased resistance in arteries
decreased blood flow
to lung cause increased pulmonary
artery pressure
Decreased Back flow of blood in right
perfusion in lung
ventricle
Necrosis Increased workload on right
of some lung tissue
side of heart
Right ventricular failure
Decreased cardiac output
Shock
CLINICAL
MENIFESTATION
 Chest pain
 Pleuriticpain (Pain during inhalation &
exhalation)
 Dysphnea
 Cynosis
 Tachephnea
 Tachycardia
 Shock and in some cases patient dies suddenly
 DIAGNOSIS
1. History and Physical examination
2. X- ray chest
3. ECG ( Electrocardiogram)
4. Pulmonary angiogram
5. Lung ventilation perfusion scan
6. ABG (Arterial blood gas) analysis
7. Coagulation tests
8. Complete blood count
 MANAGMENT
 Management is depends on severity of symptoms:
 Emergency management
 Oxygen therapy and mechanical ventilation
 Thrombolytic agents are administered for quick
dissolution of thrombus.
 ECG monitoring
 Vasopressures, Inotropic agents(Dopamine) or
antidysrhythmic drugs for supporting circulation.
 IV fluids
 Subsequent management
 Anticoagulants
o Heparin – IV
o Warfarin – oral tablet
 Surgical intervention
+ Goal is to prevent embolus to reach lungs
 Embolectomy- removal of embolus
 Percutenious thrombolysis
 Intraluminal filter in IVC (Inferior vena cava)
 NURSING MNAGEMENT

Assistance during emergency treatment
 Assessment and monitoring of vitals
 Careful administration of drugs and
information should be given about side effacts
of drugs
 Patient education and counselling
 Provide psychological support to the patient
and his/her family members
 All mandatory care of operated patient