Pulmonary Embolism

WHAT YOU SHOULD KNOW:

Pulmonary (PUL-mo-ner-ee) embolism (EM-boh-lizm) is the sudden blockage of an artery (blood vessel) in the lungs by an embolus. An embolus is usually a blood clot, but may also be fat, air, or tumor cells that are in the blood stream. Signs and symptoms of a pulmonary embolism include chest pains, fast heartbeats, sudden shortness of breath, and trouble breathing. Treatment may include medicines and surgery to remove or break up the clot. Pulmonary embolism is a serious condition. Chances of survival are better with early diagnosis and treatment.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Pulmonary embolism, if not treated, can cause damage to your lungs and other body organs. Once you have had a pulmonary embolism, your chances of getting another embolism are higher. Your chances of another embolus or bleeding may also be higher if you do not take your medicine. This serious condition, if left untreated, may cause death. Ask your caregiver if you have questions about pulmonary embolism, your medicines, and its treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Rest:

Keep the head of your bed raised to help you breathe easier. You can also raise your head and shoulders up on pillows or rest in a reclining chair. If you feel short of breath, let caregivers know right away.

Blood gases:

This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Oxygen:

You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

Pulse oximeter:

A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

Pneumatic boots:

Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

Vital signs:

Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

Tests:

You may need the following tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• Computed tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your lungs. Your caregivers look at the pictures of your lungs. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps the clot show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
  
  
• Pulmonary angiogram: A pulmonary angiogram is done to check for problems with blood flow in your heart and lungs. A catheter (long, thin, bendable tube) is placed in a vein in your neck, under your collarbone, or in your groin. The groin is the area where your abdomen meets your upper leg. The catheter is then pushed into the pulmonary artery. Dye is put into the catheter. Chest x-rays are taken after the dye goes to your heart and lungs. The dye helps the blood vessels show up better on these x-ray pictures. Tell your caregiver if you are allergic to shellfish, as you may also be allergic to the dye used for this test.
  
  
• Doppler ultrasound: This is a test that uses sound waves to see your veins on a TV-like screen. A doppler ultrasound study may also be called a duplex scan. Caregivers look for clots in the veins near the area of your pain and redness. You also may be able to hear your blood flow during this test.
  
  
• V/Q Scan: This is a ventilation (V) and perfusion (Q) test. This test is also called a VP scan. A V/Q scan is a two-part test which takes pictures of your lungs to look for certain lung problems.
  
  
  • During the perfusion part of the test, radioactive dye is put into your vein (blood vessel). The blood carries the dye to the blood vessels in your lungs. Pictures are taken to see how blood flows in your lungs.
    
    
  • During the ventilation part of the test, you breathe in special gas. Pictures are taken to see how well your lungs take in oxygen.

Treatment options:

• Medicines:
  
  
  • Blood thinners: This medicine helps stop clots from forming in your blood.
    
    
  • Warfarin: Warfarin is a type of medicine that helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Using warfarin may cause you to bleed or bruise more easily. If you are taking warfarin:
    
    
    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
      
      
    • Many medicines cannot be used when taking warfarin. Talk to your caregiver about all of the other medicines that you use. Tell your dentist and other caregivers that you take warfarin. Wear a bracelet or necklace that says you are taking this medicine.
      
      
    • You will need to have regular blood tests while taking warfarin. Your caregiver uses these tests to decide how much medicine is right for you to take. Take warfarin exactly how your caregiver tells you to. Tell your caregiver right away if you forget to take the medicine, or if you take too much.
      
      
    • Talk to your caregiver about your diet. Warfarin works best when you eat about the same amount of Vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods.
    
    
  • Clot busters: This medicine helps break apart clots. It is given IV and may be given at the same time as other blood thinners. This medicine could save your life because blood clots in the heart, lungs or brain can kill you. Be careful because you may bleed or bruise easily.
  
  
• Surgery: Surgery may be done in people who have bleeding problems and who have problems with medication. Examples are a catheter thrombolysis, embolectomy, or putting filters in large blood vessels of the body to catch clots.

Preventing blood clots:

You may need to take medicine to thin your blood. Blood thinning medicine helps prevent blood clots from forming in your veins. This medicine makes it easier for a person to bruise and bleed. You will need regular blood tests while taking this medicine. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use. Physical activity helps prevent blood clots. Caregivers will help you be as active as possible.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Pulmonary Embolism (Inpatient Care)