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The lecture Pulmonary Embolism (PE): Management by Sharon Bord, MD is from the course Respiratory Emergencies.
In the management of pulmonary embolism, what is the recommended medication for patients with cardiac compromise or with a saddle embolus?
In the emergency department, what medication(s) may be given to a patient suspected to have pulmonary embolism but confirmation testing is delayed?
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Great lecture given by a competent speaker. But Dr Bord let us down a little by not elaborating on a clinical teaching point and pearl of wisdom that she may have wanted to talk about in more detail. She makes several references to the subtle presentations PE can take and gives two personal examples in her introduction. She also encourages us to follow our gut instinct if PE is on our minds as a likely diagnosis. I have learnt that if you go looking for text book presentations then you are on the wrong track, and to some extent this lecture encourages us to think text book. One of the most confounding and frustrating aspects of PE is that it can present in many ways - it's a mischievous demon. For me shortness of breath is the only reliable symptom. I would like a warning given to include PE in the differential diagnosis of any patient presenting with shortness of breath. However, despite my warning PERC and Wells are a good aid for getting you out of a misdiagnosis, but you have to be thinking PE to begin with. If, as clinical educators, we pushed this point in 101 then perhaps more PEs could be picked up earlier.