This is the podcast, ICU rounds.

My name is Dr. Jeffrey Guy.

I'm an associate professor of surgery and director of the Burns Center

at the Vanderbilt University School of Medicine in Nashville, Tennessee.

The diagnosis and treatment of a pulmonary embolism is perhaps one of the most feared complications

that occur in a critically ill or injured patient. In surgical patients, a great amount of energy

is placed on deterring the development of deep venous thrombosis, which subsequently develop into

pulmonary emboli, which it can be a potentially fatal

complication. I'll never forget a patient I saw once as a resident who was up walking around

on a post-op surgical patient, and as he walked past the nurse's station, the patient literally

fell and when the full cardiopulmonary arrest from a sudden cardiac death, which was later

found to be secondary to a pulmonary

embolism. Depending on the clinical presentation, a pulmonary embolism could have a fatality

that diagnosis of pulmonary agent or from 1 to 60 percent, who really is complaining

of something such a shortness of breath, chest pain, sustained hypotension without any obvious cause,

such as from a GI bleed or traumatic bleed or

perhaps even sepsis. The diagnosis is confirmed by objective tests on only about 20% of the patients.

Now, in the United States, we have a very low threshold for the potential diagnosis and workup of a pulmonary embolism.

So in the United States, that diagnosis is confirmed in less than 20% of the time.

Now, the diagnostic workup for these patients is actually customized the severity of the patient's

clinical presentation, or if the patient's human dynamically stable or unstable, are they able

to transport easily in a radiology?

...