ABSTRACT
Venous thromboembolic disease and pulmonary embolism (PE) remain relatively common, potentially fatal events for trauma and acute care surgical patients. Management of patients at risk for venous thromboembolism has evolved as well. Patients with deep vein thrombosis were routinely immobilized in hopes of avoiding disrupting a clot and causing PE. Determining the pre-test risk of PE is a key step in evaluation of a suspected PE, as interpretation of imaging results is dependent on the pre-test probability. Systemic therapeutic anticoagulation is the cornerstone of preventing future PE, but as an acute treatment for PE, anticoagulation is imperfect. In cases with hemodynamic instability secondary to PE, lytic therapy or embolectomy may be used. The classic clinical picture of a patient with PE is the sudden onset of pleuritic chest pain, tachypnea, dyspnea, hemoptysis, and in severe cases, cardiovascular collapse.
