How to Detect a Pulmonary Embolism

How to detect a pulmonary embolism and a diagnosis of pulmonary embolism should always be in the back of your mind as a differential diagnosis in any patient who is hyperventilating for no apparent reason.

If you assess a patient in respiratory distress, who, on ausculatation has clear lung sounds and air entry into the bases, you must consider a pulmonary emobolism as a cause. A pulmonary emobolism is a blood clot (or thromobosis) in the lung. It can be on one side of the lung or both, and it may be lodge in the saddle of the pulmonary arteries (where the pulmonary arterieis bifurcates into the two lung fields), and there may be multiple emboli.

A pulmonary embolism is a medical emergency with very high mortality rates.

 

How do I detect a pulmonary emobolism?

The most common techniques for detecting a pulmonary emobolism include:

1. Recognising a patient is in respiratory distress;

2. Clear lung sounds and air entry to bases on ausculatation;

3. Previous medical history of cardiovascular disease, including obesity, ischaemic heart disease, high cholesterol or regular cigarette smoking;

4. Recent history of prolonged sedentary positioning, such as a long international flight;

5. Recent history of a fracture long bone, which may result in the development of a fat emobolism.