Round 15 (Syncope)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode.











Initial Vitals











* Temp 100.2* HR 132* RR 28* BP 105/69* O2 85%











Critical Actions











* Give supplemental Oxygen* Diagnose Pulmonary Embolism* Administer Heparin* Assess contraindications for tPA* Administer tPA











Final Diagnosis











Massive Pulmonary Embolism











Tips and Tricks











* Reassess vital signs after interventions* Obtain collateral history from EMS and family* Make sure your diagnosis fits the patient’s symptoms! (EG don’t diagnose pneumonia based on a consolidation on CXR if the patient doesn’t clinically have pneumonia)











Further Reading











Submassive and Massive PE (EMCrit)