Embolism

Definition

An embolism is the sudden obstruction of a blood vessel by an embolus, a detached clot, fat globule, air bubble, amniotic fluid, tumor fragment, or foreign material that has traveled through the circulation.

Types

• Pulmonary embolism (PE): Usually from lower-extremity DVT; dyspnea, tachycardia, pleuritic chest pain, hemoptysis.
• Arterial embolism: Causes ischemia of organ/limb (stroke, MI, mesenteric ischemia).
• Fat embolism: After long-bone fracture, such as triad of respiratory, neurologic, and petechial rash.
• Air embolism: Central line complication; left lateral Trendelenburg position.
• Amniotic fluid embolism: Rare, catastrophic obstetric event.

Nursing Interventions

Suspected PE: administer O2, place in semi-Fowler's, obtain D-dimer, CTA or V/Q scan. Anticoagulate with heparin. Monitor for shock and right heart failure. Prepare for possible thrombolysis or embolectomy. Prevent future PE: SCDs, early ambulation, LMWH prophylaxis.

NCLEX Relevance

Sudden dyspnea + tachycardia + pleuritic pain = PE.