Case Introduction

You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode.

Initial Vitals

  • Temp 100.2
  • HR 132
  • RR 28
  • BP 105/69
  • O2 85%

Critical Actions

  • Give supplemental Oxygen
  • Diagnose Pulmonary Embolism
  • Administer Heparin
  • Assess contraindications for tPA
  • Administer tPA

Final Diagnosis

Massive Pulmonary Embolism

Tips and Tricks

  • Reassess vital signs after interventions
  • Obtain collateral history from EMS and family
  • Make sure your diagnosis fits the patient’s symptoms! (EG don’t diagnose pneumonia based on a consolidation on CXR if the patient doesn’t clinically have pneumonia)

Further Reading

Submassive and Massive PE (EMCrit)