Round 15 (Syncope)

Summary: <br> CAUTION: THESE NOTES CONTAIN SPOILERS!!!<br> <br> <br> <br> Case Introduction<br> <br> <br> <br> You are working a shift at Clerkship General when a 51 year old female is brought in after a syncopal episode.<br> <br> <br> <br> Initial Vitals<br> <br> <br> <br> * Temp 100.2* HR 132* RR 28* BP 105/69* O2 85%<br> <br> <br> <br> Critical Actions<br> <br> <br> <br> * Give supplemental Oxygen* Diagnose Pulmonary Embolism* Administer Heparin* Assess contraindications for tPA* Administer tPA<br> <br> <br> <br> Final Diagnosis<br> <br> <br> <br> Massive Pulmonary Embolism<br> <br> <br> <br> Tips and Tricks<br> <br> <br> <br> * 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)<br> <br> <br> <br> Further Reading<br> <br> <br> <br> Submassive and Massive PE <a href="https://rebelem.com/rebelcast-crashing-asthmatic/#:~:text=Acute%20severe%20asthma%2C%20formerly%20called%20status%20asthmaticus%2C%20is,medical%20emergency%20that%20requires%20immediate%20recognition%20and%20treatment.">(EMCrit)</a><br>