d. Fat Particles. Other substances in addition to blood clots may cause an
obstruction in an artery. Particles of fat may break loose during a severe injury to the
body, be carried by the bloodstream, and lodge in an artery.
e. Amniotic Fluid. During childbirth, amniotic fluid may enter the mother's
circulatory system and move into the mother's lungs.
The signs and symptoms of pulmonary embolism vary with the size of the
obstruction. The typical patient may have a sudden onset of severe, unexplained
dyspnea (sharp chest pain made worse by coughing or deep breathing), tachycardia
(rapid heart rate, over 100 beats per minute), labored breathing, and falling blood
pressure. A chest examination may show no abnormalities, however.
5-10. DIAGNOSIS/PHYSICAL EXAMINATION
a. Perform an Auscultation Examination. Listen for atelectatic rales (fine,
rattling sounds in a lung which is not completely expanded). Also, listen for localized
wheezes (high-pitched notes like musical sounds).
b. Take the Pulse. The pulse rate may be over 100 beats per minute
A deep tenderness in the calf area of the leg may indicate phlebitis.
a. In the Field. Treatment is largely supportive since definitive therapy with
anticoagulants requires hospitalization. Follow this procedure:
Ensure an open airway.
Assist ventilations as needed.
Administer oxygen in the highest possible concentration.
(4) Establish an IV lifeline with a solution of water with five percent dextrose
(D5W) and monitor the patient's cardiac rhythm.
b. In the Hospital. Treatment in the hospital includes these procedures:
Analgesics to relieve pain, perhaps a narcotic.