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Pulmonary Embolism:

Weekly question from archived Gold Cross CEU Articles.
CEU Test #95 "Lung Diseases". by Sylvie Mulvaney and Louis A. Sforza.

Which of the following is a known cause or contributing factor to pulmonary embolism?
a. Virchow's Triad
b. history of cigarette smoking
c. left ventricle
d. all of the above

Answer:
Pulmonary Embolism
Pulmonary embolism (PE) occurs when a blood clot lodges in an artery in the lung, blocking blood flow to part of the lung.
Pathophysiology – The more vessels blocked, the more severe the condition, obviously. Blood clots often originate in the legs and travel up in the inferior vena cava, through the heart’s right atrium and right ventricle before reaching the pulmonary arteries. (see figure 5)
Picture
 In cases of atrial fibrillation, clots can originate in the right atrium of the heart. Due to its wide range of differential diagnoses, PE often is difficult to identify in young people who typically are in good health and have good pulmonary reserve. For people with comorbid factors such as CHF, COPD or hypertension, even a small clot can cause symptoms. A thorough patient history – and a high index of suspicion – can help the EMT narrow the list of probable causes of the patient’s symptoms.

Causes – Three predisposing factors are:
local trauma to a vessel wall; stasis of the blood; and hypercoagulability. This is known as Virchow’s Triad. The EMT should look for a history of cigarette smoking, a prior blood clot, sedentary lifestyle, long-bone fractures, pregnancy, recent hip or leg surgery, contraceptive use or stasis of position, as would be the case with a long car trip or air travel.

Assessment
– PE patients can present with acute onset of dyspnea without explanation, diaphoresis, cough, anxiety, tachycardia and tachypnea, complaints of pleuritic chest pain or lower back pain, a change in mental status due to hypoxia, cyanosis, even sudden death. Good auscultation of lung sounds is a must. Interventions – Ensure adequate oxygenation with either supplemental oxygen via nasal cannula, nonrebreather mask or a bag-valve mask and transport the patient promptly to the nearest emergency room.
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  • Home
  • Recruitment & Retention
    • Recruitment >
      • Recruitment Ideas
      • Develop a Recruitment Plan >
        • EMT Welcome Package
        • Explain EMT Requirements
        • Explain EMT Benefits
        • Explain EMT Commitments
        • Explain EMT Tasks
      • How To Recruit With Your Website >
        • Website Contents >
          • Home Website
          • About Us Website
          • Join Website >
            • NJ EMT Benefits WS
            • NJ EMT Requirements WS
            • NJ EMT Commitments WS
            • NJ EMT Tasks WS
            • Sample Membership Forms
          • Photo Gallery New Good EMT Websites
          • Members Only New Good EMT Websites
          • Contact Us New Good EMT Websites
        • EMS Website Development Sevices
      • Use an Online Membership App Form
    • Retention >
      • Retention Ideas
      • Provide Recert Info
      • Provide Members Only Section
      • Provide Photo Gallery
  • Training
    • How To Become An EMT In NJ
    • Newest CEU Courses
    • Training Locations By Counties >
      • Training Locations A - I >
        • Atlantic County Training Locations
        • Bergen County Training Locations >
          • Bergen County EMS Center
          • Bergen New Bridge Medical Center
          • Holy Name Hospital Teaneck
          • HUMC
          • NJ Mobile Health Care
          • The Valley Hospital
          • S. Carol White Academy
        • Burlington County Training Locations
        • Camden County Training Locations
        • Cape May County Training Locations
        • Cumberland County Training Locations
        • Essex County Training Locations
        • Gloucester County Training Locations
        • Hudson County Training Locations
        • Hunterdon County
      • Training Locations J - R >
        • Mercer County Training Locations
        • Middlesex County Training Locations >
          • Saint Peter's Hospital
        • Monmouth County Training Locations
        • Morris County Training Locations >
          • Atlantic Training Center
        • Ocean County Training Locations
        • Passaic County Locations >
          • Public Safety Academy of Wayne
          • St. Joseph's Hospital
          • Wanaque Training
      • Training Locations S - Z >
        • Salem County Training Locations
        • Somerset County Training Locations
        • Sussex County Training Locations
        • Union County Training Locations
        • Warren County Training Locations
    • Recertification >
      • How To Recert
      • Recertification Classes
    • Training Requirements
    • NJ DOH on ePCR
    • NJ DOH OEMS >
      • Contact DOH
      • State Protocols
      • NJ DOH Webinar Series
      • NJ DOH Other Training
      • Scene Photos Prohibited
    • NJOHSP >
      • NJOHSP Training Classes
      • VILT Training
    • NJEMS Field Guide
    • Medical Emergencies >
      • Airway
      • Blood Pressure >
        • Palping a BP
      • Cardio Vascular >
        • Pulmonary Embolism
      • Respiratory System >
        • Adequate Breathing
        • Lung Diseases
      • Kidney Diseases >
        • Kidney Disease
        • Kidney Dialysis
      • Narcan
      • Stroke
    • Trauma Emergencies >
      • Selective Spinal Restriction
      • Splinting and Bandaging
      • First Aid
      • Roller Gauze
      • Transporting Children
    • Equipment
    • ICS
    • Safety Docs
  • EMSCNJ
    • Gold Cross Magazine >
      • Gold Cross Information
      • Archived Gold Cross CEU Articles
    • EMS Council Of NJ
    • EMSCNJ Benefits
    • President's Newsroom >
      • 911 Monument
    • New Officers 2022
    • Keyport Cadet Competition 2019
    • EMSCNJ Scholarships >
      • 2022 Scholarships
      • 2021 Scholarships
      • 2019 Scolarships
      • EMSCNJ 2018 Scholarship WInners
      • EMSCNJ 2017 Scholarships
      • EMSCNJ 2016 Scholarship Winners
    • Northern Area >
      • 3RD District
      • 6th District
      • 12th District
      • 20th District >
        • 20th District CYG
    • Central Area
    • Southern Area
    • District Opt In
  • EMS Links
    • NJ DOH
    • NJOHSP
    • Mesolthelioma Center
    • Morris County EMS Alliance
    • Other Links
  • EMS Workforce
    • EMS Workforce
  • Contact