Pulmonary Thrombosis ​

What is it?​

• Refers to a pulmonary embolism (PE) ​
• When a blood clot blocks the main artery (or arteries) of the lungs, thus blocking air exchange and causing heart failure.  In severe cases, it can cause cardio-respiratory collapse (cardiac arrest)​

Clinical Findings: ​

• JVD​
• Clinical signs of DVT​

 *Note that these signs are very difficult to identify in a patient who is VSA​

Risk Factors:​

• Deep vein thrombosis (DVT)​
• Hx Cancer, pregnancy, or recent surgery

Why Leave Early

• There is a "hail mary" treatment of thombolytics (TPA)  in-hospital ​
• Note that this treatment has very poor efficacy in the setting of cardiac arrest

When to Leave Early

• In the vast majority of times you will NOT: Given the difficulty in identifying PE in the pre-hospital setting and the poor efficacy of the "hail mary" treatment, focus on the basics, utilizing your excellent quality resuscitation via the Cardiac Arrest Medical Directive​
  • One exception would be when you have a VERY HIGH degree of suspicion of PE, you may consider early transport. ​
• Example of high degree of suspicion:​
• The patient was diagnosed with a DVT, has not been compliant with their anticoagulant and became suddently and severely SOB prior to arrest.

In Summary

• Pulmonary Thrombosis refers to a PE - when a blood clot blocks arteries of the lungs. ​
• Thrombolysis is a potential treatment available in-hospital to break down the clot ​
• Consider leaving very early ONLY when you have a VERY HIGH degree of suspicion for a PE as the cause of arrest:​
  • A very clear incident history AND a clear PMHx highly suggestive of PE (e.g. known PE or DVT) +/- clinical signs

No additional resources available for this #SWORBHPTip.