Massive Pulmonary Embolism

Haemodynamic instability + suspected PE

First 30 seconds

  1. 1ABCDE, high-flow O₂
  2. 22 large-bore IV, bloods + ABG
  3. 3Bedside echo (RV strain, McConnell)
  4. 4Call cardiology / ICU / thrombolysis team

PE with sustained hypotension (SBP <90 mmHg ≥15 min) or requiring vasopressors not explained by other cause.

A

Airway

  • Patent? Talking? Stridor?
  • Suction, jaw-thrust, adjuncts, definitive airway if needed
B

Breathing

  • RR, SpO₂, auscultate, percuss
  • O₂ to target sats, NIV / intubate as required
C

Circulation

  • HR, BP, cap refill, JVP
  • 2× large-bore IV, bloods, monitor, ECG
D

Disability

  • AVPU/GCS, pupils, glucose, temp
E

Exposure

  • Full exposure, skin, rash, bleeding, lines, infection source
View flowchart algorithm
WardRound

WardRound

Clinical Decisions in Seconds