IPHREHAB : PULMONARY EMBOLISM

IPHREHAB


PULMONARY EMBOLISM:

• PAIN CHEST
• PAIN SEVERE RESEMBLE  LIKE THAT OF MYOCARDIAL INFARCTION 
• DYSPNOEA-SEVERE
• COUGH
• HAEMOPTYSIS
• PLEURAL RUB

PULMONARY EMBOLISM

Flight-related Deep Vein Thrombosis (DVT) 

• AN IMPORTANT ENTITY
• KNOWN AS “ECONOMY CLASS SUNDROME”
• SEEN IN PERSONS ON LONG DISTANCE TRAVEL
• OBESE,, OEDEMATOUS
• DEHYDRATED
• COAGULATION DISORDERS

INVESTIGATIONS

1. COMPLETE HAEMOGRAM
2. BT, CT, PROTHROMBIN TIME
3. VENOGRAPHY
4. CT SCAN
5. MRI SCAN
6. ULTRA SOUND- can localize the clot.

Prevention of Pulmonary Embolism

• RISK OF PULM.  EMBOLISM IN PROX DEEP VEIN THROMBOSIS IS  50%
• IN CALF VEIN THAROMBOSIS IS 5-20
• ANTOCOAGULANTS;-  Heparin 7500 Units IV initially, followed by 1000 Units hourly. Should be maintained for 5-7 day

PULMONARY EMBOLISM

• Heparin can be given SC and should be for 3-5 months
• THROMBOLYSIS:- Streptokinase, Urokinase can be used. They are less effective.
• Warfarin can be used also for long time

• LOW DOSE HEPARIN may be very helpful. 5000 Units twice daily SC. It is also helpful in preventing embolsm in Surgical cases.
• ASPIRIN in low doses is also very helpful

MANAGEMENT :

Preventive

• STAND UP & WALK
• CALF MUSCLE EXERCISES
• LOT OF FLUIDS
• NO ALCOHOL
• NO SMOKING
• AVOID CROSS LEGS IN POSTURE
• WEAR LOOSE CLOTHING

MANAGEMENT

• PHYSIOTHERAPY
• REDUCE WEIGHT
• ELEVATE YOUR LEGS
• STOCKINGS
• ROLE OF ASPIRIN
• LOW DOSE HEPARIN
• WARFARIN

CONCLUSIONS

• DVT is very common condition
• It is common in elderly diabetic especially travelling by air on long flights
• IN USA 600,000 cases are diagnosed  every year
• 1% can lead to Pulm.Embolism
•  Pulm. Embolism  may be fatal
• It is Preventable
• Exercise & anticoagulant play important part.