create a flyer/pamphlet including a) signs and symptoms: b) potential causes; c) assessment; d) management (pharmacologic and nonpharmacologic for Pulmonary embolism (PE)
Pulmonary Embolism (PE) — Quick Flyer
Target audience:
Patients, caregivers, and healthcare staff
Signs and Symptoms
Sudden shortness of breath or rapid breathing (dyspnea)
Pleuritic chest pain (sharp pain worsened by breathing or coughing)
Rapid or irregular heartbeat (palpitations)
Cough, sometimes with bloody sputum (hemoptysis)
Dizziness, lightheadedness, or syncope (fainting)
Sudden anxiety or sense of doom
Low oxygen saturation, cyanosis (bluish lips or skin) in severe cases
Signs of deep vein thrombosis (DVT): leg swelling, pain, warmth, or redness
Potential Causes / Risk Factors
Deep vein thrombosis (most common source of emboli)
Recent surgery, especially pelvic or orthopedic (hip/knee)
Prolonged immobility (long flights, bed rest)
Malignancy (cancer) and certain cancer therapies
Pregnancy and postpartum period
Hormonal therapy or oral contraceptives
Inherited thrombophilias (e.g., Factor V Leiden, prothrombin mutation)
Obesity, advanced age, smoking, and prior VTE (venous thromboembolism)
Assessment
Immediate evaluation of airway, breathing, circulation; ABCs and oxygen as needed
Clinical probability scoring (Wells score, Geneva score)
Pulse oximetry and arterial blood gases if indicated
Electrocardiogram (ECG) to assess hemodynamic impact and rule out other causes
Chest imaging:
CT pulmonary angiography (CTPA) — gold standard for diagnosis
Ventilation-perfusion (V/Q) scan when CTPA contraindicated
Compression ultrasound of lower extremities if DVT suspected
Laboratory tests:
D-dimer (useful to rule out PE in low-intermediate probability)
Complete blood count, coagulation profile, renal and liver function
Hemodynamic assessment: blood pressure, signs of right heart strain; consider bedside echocardiography for right ventricular dysfunction
Management
General principles
Treat suspected PE promptly — do not delay anticoagulation if high suspicion and no contraindication
Stabilize airway, breathing, and circulation; provide supplemental oxygen and hemodynamic support
Risk stratify (massive/high-risk, submassive/intermediate-risk, low-risk) to guide therapy
Pharmacologic Management
Initial anticoagulation:
Unfractionated heparin (IV) — preferred if high bleeding risk or potential need for thrombolysis/intervention
Low molecular weight heparin (LMWH) — e.g., enoxaparin, for most patients
Fondaparinux — alternative in some cases
Direct oral anticoagulants (DOACs) for treatment and long-term therapy:
Apixaban, rivaroxaban, dabigatran, edoxaban (choice depends on patient factors and contraindications)
Some DOACs require initial parenteral anticoagulation or lead-in dosing
Thrombolysis (systemic fibrinolysis) — consider for massive PE with hemodynamic instability
Catheter-directed thrombolysis or embolectomy — for selected patients or when systemic thrombolysis contraindicated
Inferior vena cava (IVC) filter — consider if anticoagulation contraindicated or recurrent PE despite adequate anticoagulation
Duration of anticoagulation:
Provoked PE (transient risk): typically 3 months
Unprovoked PE or ongoing risk factors: extended therapy individualized based on bleeding risk
Nonpharmacologic Management
Oxygen therapy and respiratory support as needed (high-flow oxygen, noninvasive or invasive ventilation for severe cases)
Mechanical thrombectomy/thromboaspiration for selected patients
Compression stockings for DVT prevention and symptom relief (use per guideline recommendations)
Early mobilization and physiotherapy after stabilization
Smoking cessation, weight management, and addressing modifiable risk factors
Patient education on signs of recurrence, medication adherence, and when to seek immediate care
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