The EM Educators Series: Pulmonary Embolism

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!


Case 1:

A 35-year-old male presents with tachycardia and hypoxia. His lungs are clear, and his cardiac exam is normal other than the tachycardia. ECG demonstrates sinus tachycardia, and chest x-ray is normal.

 

Case 2:

A 57-year-old female presents with chest pain that worsens with inspiration. She is also tachypneic and has dyspnea with exertion.

 

Case 3:

A 28-year-old female G2 P1 at 32 weeks presents with pleuritic chest pain and shortness of breath that has worsened over 3 days. Her vital signs are normal, but the ECG reveals right heart strain.

 

Considerations:

  • What are the major risk factors for PE?
  • What are the various types of PE, and how can PE present?
  • What is the differential for shortness of breath and normal lung exam/unexplained hypoxia?
  • What does risk stratification entail, and what tools are available?
  • What diagnostic tools do we have in the ED?
  • What is the ED management of PE?
  • Who can be discharged, and who requires admission?

 

Suggested Resources:

 

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