treatment of a medium sized pulmonary embolus
Last reviewed 01/2018
Consult expert help:
- sit the patient up (unless there is severe shock)
- administer oxygen, up to 100%
- administer morphine 10 mg i.v., especially if patient in pain
- start heparin
- low molecular weight heparin is as effective as unfractionated heparin (1)
- give patient thrombo embolism deterrent stockings to wear
- patients have and require high right heart filling pressures; treatment with diuretics and vasodilators is deleterious
- once stabilised on heparin, commence warfarin treatment; give loading dose of 10 mg daily for two days; adjust third daily dose according to the patient's INR. Aim to maintain the INR at 2.5-3.5X normal. In general, treatment with warfarin is for 6 months for a first PE (1)
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