If you want to view a video tutorial on how to construct a care plan in nursing … Most commonly emboli are detached thrombi from the deep veins of the legs. Percutaneous insertion technique in radiology (Feied & Handler, 2000), a. (2010). Composed of elastic connective tissue, smooth muscle, and fibrous connective tissue, 2. Lower pressure and resistance than systemic circulation; average pulmonary artery pressure +25/10 mm Hg, and mean of 15 mm Hg, 5. Mayo clinic health oasis. Join the nursing revolution. Medical & Surgical Nursing (Notes) Pulmonary Embolus Nursing Management. 0 comments YouTube Link Tuesday, 5 January 2021. Jobs are available in hospitals, schools, private organizations, government organizations, and more. Nuclear medicine lung scan (American Thoracic Society, 2010), a. Assesses airflow and pulmonary circulation to identify areas that may have normal air exchange but abnormal blood flow indicative of obstruction, b. MRI: has been used to make diagnosis but not cost effective or safe in critically ill patients; respiratory and cardiac artifact limit imaging, b. Most serious is intracranial bleeding: 1% incidence (Wheeler & Anderson, 1996), c. Intraperitoneal bleeding may be life threatening, d. Close monitoring: intensive care if patient unstable, f. Studies have not shown improved overall mortality compared to heparin (Erdman et al., 1997), a. Massive/submassive PE with hemodynamic compromise, b. 2. 1,2 When a PE is present there is ventilation of lung tissue but a lack of perfusion, resulting in impaired gas exchange. Retrieved from www.thoracic.org/education/breathing-in-america/index.php, accessed November 30, 2012. This is thought to be due to improved diagnosis and treatment of DVT, with wider acceptance of prophylaxis and public education regarding prevention. Monitor oxygen saturation either continuously or with each assessment and p.r.n. Massive PE without hemodynamic compromise, c. Submassive PE in patients who cannot tolerate further cardiopulmonary compromise, 5. Malignancy: tumors secrete clotting factor, C. Prevention of PE in surgical and trauma patients (refer to Table 19-1 in Chapter 19, Superficial Thrombophlebitis and Deep Vein Thrombosis), 2. Price, & L. M. Anderson (Eds. D-dimer assay (Thompson & Hales, 2004), a. a. Caprini, J. Nurse Salary (Income) Statistics. a. Assess pain on a scale of 1 to 10 minimally every 8 hours and p.r.n. Aklog, L., Williams, C. S., Byrne, J. G., & Goldhaber, S. Z. Pulmonary embolism is the third leading cause of death from cardiovascular disease, exceeded only by ischemic heart disease and stroke, and may be the most common preventable cause of death in the world (Wheeler & Anderson, 1996). Useful to evaluate for myocardial infarction, arrhythmia, or other cardiac causes of symptoms, a. is a 54-year-old tree service owner who suffered a back injury after falling out of a tree. Precautions and guidelines for patient care, 1) Careful patient selection/evaluation with attention to neurologic history, 2) Laboratory monitoring prior to infusion: CBC, platelet count, aPTT, and PT, and tests for coagulation defects (e.g., fibrin degradation products); repeat as indicated during and after therapy, 3) Fecal occult blood sample prior to therapy, 4) Minimal venipuncture and arterial puncture, 5) Short infusions via pulmonary artery catheter (usually inserted in groin) directed into thrombus; adequate pressure on site once catheter removed, 6) If possible, avoidance of lytic agents as emergency treatment: can be used successfully as an elective procedure via peripheral vein with less bleeding risk (Wheeler & Anderson, 1996), 7) Avoid administration of heparin: if heparin recently given, wait until aPPT is less than 1.5 control. Oxygen via nasal cannula, mask, or both, 3. Home environment and support system concerns, a. Factors that can influence income include location (some states pay more than others), experience (nurses with decades of experience will earn more than new nurse graduates), specialty (some specialties pay more than others), certification (achieving certification could increase pay), industry, and more. According to the BLS statistics, over 60% of registered nurses work in a hospital setting, while others work in other settings such as physician’s offices, outpatient facilities, and home-health agencies. Deep vein thrombosis occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. Immediate examination upon presentation includes the following: Integument: diaphoretic; otherwise, skin intact without bruises or rash, Cardiovascular: apical pulse 120, regular without murmurs, S1, S2. Learn more about nursing here. Retrieved from www.emedicine.com/EMERG/topic490.html. Stamford, CT: Appleton & Lange. Overview. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. Deep vein thrombosis is a part of a condition called venous thromboembolism. Pulmonary embolism and deep vein thrombosis. Absolute: active bleeding, cerebrovascular disease/event or procedure within past 2 months, b. Produces area of lung that is ventilated but underperfused (ischemia and organic dysfunction), a. Journal of Advanced Nursing, 23(4), 763–770. There are many different types of nurses. Patient will be able to perform activities of daily living, a. Mayo clinic health oasis. (2001). Retrieved from www.repro-med.net/papers/apa.html, Gallus, A. S. (1998). Pulmonary embolism. Heit, J. Once lytic therapy complete, do not resume heparin until aPPT <80 seconds (Walsh & Rice, 2004), 1) Hemorrhage: major bleeding occurs in approximately 20% (Erdman et al., 1997). American Journal of Respiratory and Critical Care Medicine, 160, 1043–1066. If bleeding continues, 5 g doses of E-aminocaproic acid (EACA) may be given, 2) Allergic reaction: mostly associated with streptokinase, although mild allergic reactions to other agents have been reported; urticaria, itching, flushing, nausea, headache, alteration of blood pressure. Cornerstone of treatment for PE (Wheeler & Anderson, 1996), b. Low-molecular-weight heparin may reduce hospital stays. Pulmonary embolism is a common and potentially fatal cardiovascular disorder that must be promptly diagnosed and treated. Pulmonary embolism is the third leading cause of death from cardiovascular disease, exceeded only by ischemic heart disease and stroke, and may be the most common preventable cause of death in the world (Wheeler & Anderson, 1996). 1 Most PEs arise from the legs. Pulmonary embolism is a frequent hospital-acquired condition and one of the most common causes of death in hospitalized clients. Avoid constrictive clothing and footwear: compression support hose should not be overly binding and is best obtained from experienced compression garment fitter, b. Thrombolytic therapy unavailable or contraindicated, c. Most patients die before they can be transported to operating room or stabilize and no longer require procedure, d. Rarely used electively for patients with chronic PE where clot did not naturally lyse, a. Balloon-tipped catheter is inserted into the pulmonary artery via incision in groin, b. Nightingale, who was the daughter of wealthy British family, devoted her early years as a nurse improving the hospital conditions during the Crimean war. In 1859, she wrote Notes on Nursing, a 136-page book that served as an important part of the curriculum at the Nightingale School and other nursing schools established at that time. Cautious administration of intravenous fluids to avoid exacerbation of right heart failure, 8. “As a cardiac nurse for over six years, I provide daily nursing care to a wide range of patients for conditions including congestive heart failure, stroke, chest pain, chronic obstructive pulmonary disease and pulmonary embolism. 5. Our videos are designed to help you succeed in nursing school, prepare for NCLEX, and much more! Licensed practical nurses (LPNs or LVNs): average salary of $44,030; average hourly wage of $21.17. (1999). Gene Clinics, University of Washington, Seattle. You can link to our site from your blogs or university websites, or you can share us on your favorite social media sites. The epidemiology of venous thromboembolism in the community. (2003). Florence Nightingale influenced nursing so much, that even today most nursing schools require students to stand and recite the “Nightingale Pledge,” which is similar to the Hippocratic oath taken by doctors. A pulmonary embolus (PE) is a thrombus that lodges in a segment of the pulmonary arterial system, thereby causing either complete or partial obstruction of pulmonary blood flow that may result in a significant decrease of oxygenation. A deep vein thrombosis (DVT) is a blood clot that forms within the vein. 5. Anticoagulate with warfarin for 3 to 6 months (Feied & Handler, 2000), 5. Pulmonary Embolus Nursing Management. Supplemental oxygen and/or mechanical ventilation as indicated, b. Elevate head of bed; unaffected lung positioned down to allow for increased blood flow to area of continuous perfusion/ventilation (e.g., if PE in left lung, patient lies on right side), c. Assist patient with activities of daily living, e. Hydrate patient cautiously, avoiding overhydration and exacerbation of right heart failure. Siskin, G., & Cho, K. (2011). Anonymous. McCance, S. L., & Huether, S. E. (1998). 3. Acute PE, a pulmonary manifestation of a circulatory problem, is a serious condition caused by obstruction of blood flow in one or more pulmonary arteries (PA). 7. b and d. Helping Mr. D understand the risk factors for recurrence of PE can be life saving. 4. Annals of Internal Medicine, 140(11), 867–873. ), Handbook of venous disorders (pp. Welcome to Registered Nurse RN. 1. This increased to 99% if patients had low probability of PE from clinical assessment (Thompson & Hales, 2004), f. Reliance on D-dimer for PE diagnosis is limited, 2) D-dimer analyses using enzyme-linked immunosorbent assays (ELISA) yield best sensitivities (95%) for excluding PE/DVT, 3) A negative rapid ELISA is as useful as normal lung scan and negative venous duplex scan to exclude PE, 6. Ventilation scan requires inhalation of radioactive gases or aerosols followed by imaging to detect nonventilated area, c. Perfusion scan requires injection of radioactive material (albumin with technetium or iodine) followed by imaging to detect area of nonperfusion suggestive of blocked artery, d. Pre-existing lung disease (atelectasis, pneumothorax, emphysema, chronic pulmonary lung disease) may cause false-positive results: need to compare chest x-ray and patient history, e. A normal ventilation scan with abnormal perfusion scan is associated with high probability of PE, f. When clinical suspicion for PE is high, and V/Q scan read as high probability for PE, accuracy is 96% (Wheeler & Anderson, 1996), g. When clinical suspicion low and V/Q is normal, likelihood of PE very low (2% to 9%), h. Many patients have indeterminate results: further evaluation with invasive studies needed, 2. Graduated Compression Stockings in Hospitalized … Saunders. What response by the nurse is best? Walsh, M. E., & Rice, K. L. (2004). The only way we can continue to provide these FREE resources is if you help us spread the word about our website and YouTube channel. Research and Further Study (American Thrombosis Society, 2010), A. Retrieved from www.repro-med.net/papers/thromb.html, Beer, A. E., Kwak-Kim, J., Ntrivalas, E., & Chung, H. S. Acquired thrombophilia antiphospholipid antibody syndrome category 2 immune problems. Clinical assessment of venous thromboembolic risk in surgical patients. Our mission is to help aspiring nurses, nursing students, and new nurses. Divides and enters the lung at the hilus with each main bronchus and branches with the bronchus at every division (see Fig. 3. Feied, C., & Handler, J. Adjust subsequent daily dose according to the INR, with goal of 2 to 3, 3. Walk regularly/daily: may also jog, swim, cycle, 3. Introduces antigens, cells, and proteins, a. Subacute bacterial endocarditis the most common cause, 1) Vegetation is dislodged from infected valve and injected into circulation, a. Trauma induced, often fracture of large long bone (femur), 1) Globules of fat/bone marrow are released, b. Complete occlusion of bifurcation of main pulmonary artery, b. Intubation and mechanical ventilation if needed for severe respiratory distress, 4. amzn_assoc_asins = "0133249778,0781787416,B0116PRNRK,B00RD9T7IC,0323358519,B00BCFVJ7U"; Nurses earn very competitive salaries. Nursing Diagnosis: Impaired gas exchanged related to decrease pulmonary perfusion associated with obstruction of pulmonary arterial blood flow by the embolus as evidence by dyspnea, positive for Pulmonary Embolism, and abnormal pulse oximetry. While all of the presenting symptoms are nonspecific and could indicate other disorders (such as myocardial infarction), the most classic subjective symptom is dyspnea, followed by pleuritic chest, cough, hemoptysis, restlessness. New nurses can access job resources such as interview tips, nursing job resumes, and job search tools. Graduated compression stockings are recommended but are not immediately essential to stabilize the patient. Thromboembolic disorders. b. Observe/record frequency of requests for pain medication, c. Observe tolerance of activity: increased pain, tachycardia, hypertension, C. Anxiety related to dyspnea, pain, and unknown treatments/diagnostics, a. Overlap heparin and warfarin for 5 to 7 days or until INR stable at therapeutic goal for 48 hours to allow for depletion of vitamin K-dependent clotting factors, 4. 4. b. Factor V Leiden thrombophilia. Intravenous unfractionated heparin standard treatment, a. All Risk Factors for development of DVT (Virchow triad) as listed in Chapter 19, Superficial Thrombophlebitis and Deep Vein Thrombosis, a. Dosage for DVT/PE treatment: 5 mg (patient weight <50 kg); 7.5 mg (50 to 100 kg); 10 mg (>100 kg) for 5 to 9 days, c. Continue treatment until therapeutic oral anticoagulation is complete, b. Minimization/elimination of biological variability, immunogenic reactivity, and pathogenic contamination (less potential for hypersensitivity reactions), c. Shown to be as safe and effective as LMWH (Buller et al., 2004), e. Once-daily dosing; dose does not need to be calculated, a. May show nonspecific changes in T-wave, S-T segment, or axis deviation: if present, may indicate right heart strain secondary to pulmonary arterial obstruction, b. Expected patient outcomes: patient will maintain end-organ perfusion, a. 1 PE occurs in at least 650,000 people each year in the United States and is either the first or second most common cause of unexpected natural death in most age groups. Dissolution of clot via chemical lysis of fibrin component, resulting in rapid removal of intraluminal thrombus and restoration of vessel patency, a. 10% from inferior vena cava, upper extremity, and right side of heart, 3. High risk of systemic bleeding complications: double or triple compared to heparin (Erdman, Rodvold, & Friedenberg, 1997), b. ‘‘Most patients with DVT will develop pulmonary embolism and the majority of cases will be clinically unrecognized. Chronic obstructive pulmonary disease (COPD). Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2014-15 Edition, on the Internet at bls.gov. With loyalty will I endeavor to aid the physician, in his or her work, and devote myself to the welfare of those committed to my care. By the year 1938, New York State passed the first state law requiring licensing for practical nurses. The student nurse asks why the clients oxygen saturation has not significantly improved. Small doses of opiates (intravenous morphine, 1 to 2 mg) for discomfort and anxiety; avoid larger doses which may lead to respiratory depression, 6. This is an uncommon complication of PE, although some studies have shown that pulmonary infarction is more likely when the lung is already infected or congested prior to the development of pulmonary embolism (Roach & Laufman, 1955). Noninvasive venous studies (venous duplex ultrasound or impedance plethysmography), a. Head of bed should be elevated with positioning so that the good (unaffected) lung is down to maximize blood flow to perfused lung tissue. Heparin remains the cornerstone of treatment for PE. Exercise caution when using sharp items such as scissors, broken glass, and so forth, d. Wear or carry identification that indicates anticoagulation therapy, e. Seek immediate care for serious injury or head injury, 5. Skin: diaphoretic, flushed or pale evidence of shock; cyanosis, c. Respiratory: labored breathing, orthopnea, cough/hemoptysis, acute cor pulmonale, e. Extremities: peripheral edema (especially unilateral), bulging varicosities, erythema, a. Pulses usually normal unless edema diminishes ability to palpate or patient in shock, c. Skin temperature/low-grade fever, diaphoresis, a. by howie author page . amzn_assoc_search_bar = "true"; This is true whether the initial (clot) is small or large. Critically ill patient needs to be monitored: may be difficult and dangerous, c. Especially risky for patients with right heart failure, severe pulmonary hypertension, and respiratory failure; mortality from procedure <2%, d. High level of technical expertise; expensive, e. Not suitable for routine use or screening, D. Other Testing: Consider screening for familial/genetic hypercoagulabilities as discussed in Chapter 19 (Superficial Thrombophlebitis and Deep Vein Thrombosis), 1. Patient and family teaching at the time of Mr. D’s discharge should emphasize: a. Avoidance of all green leafy vegetables, b. The information obtained on other tests may be supportive but is not confirmatory, although a negative D-dimer assay essentially rules out the possibility of a PE in a patient who is otherwise at low risk and has low index of suspicion (which is NOT Mr. D). Most common signs, in order of frequency (Thompson & Hales, 2004), a. Tachypnea/hypoxemia: 70%; caused by mismatch of alveolar ventilation without pulmonary flow in that area, e. Accentuated pulmonic component of the second heart sound: 23%, f. Frequency of these findings was the same for patients without PE: no particular clinical finding is sensitive or specific enough to establish diagnosis, a. Neuro: anxiety, level of consciousness/faint or syncope, b. PEGASUS Trial Study. Clinical manifestations and diagnostic strategies for acute pulmonary embolism. Pulmonary embolism. Smoking cessation and use of a medication bracelet, d. Discussion of anticoagulation side effects and his work responsibilities. Important in identifying other cardiac or pulmonary problems which may resemble PE, b. Emedicine-Instant Address to the Minds of Medicine. All Rights Reserved. Erdman, S. M., Rodvold, K. A., & Friedenberg, W. R. (1997). b. Relationship between pulmonary embolism and pulmonary infarction: An experimental study. PE prevention for surgical and trauma patients (refer to Table 19-1 in Chapter 19, Superficial Thrombophlebitis and Deep Vein Thrombosis), 1. What veins are most susceptible for a DVT? Ask the Mayo physician. Disease Prevention/Health Promotion and Secondary Prevention, 1. Eliminates need for transport for invasive testing if positive, 5. amzn_assoc_ad_mode = "manual"; Learn pulmonary embolism nursing with free interactive flashcards. The use of either clinical probability adjusted or age adjusted D-dimer interpretation has led to … Local anesthetic and small incision in groin, b. Catheter is introduced into the femoral vein, c. Radiopaque contrast is administered and filter is placed in the inferior vena cava, with apex near the level of the lowest renal vein at approximately L2 and L3, d. Requires anticoagulation with heparin and followed by lifelong warfarin, 1) Greenfield filter: either stainless steel or titanium; only device shown to maintain patency of inferior vena cava and avoid renal vein occlusion (Greenfield & Proctor, 1996), b. Retrievable filter: may be removed between 14 and 41 days of placement or remain in place as permanent filter; reported technical success rate of 93% (Morris, Rogers, Najarian, Bhave, & Shackford, 2004), TABLE 20-1 Indications for Insertion of a Vena Cava Filter. Nursing Care Plan for: Atrial Fibrillation, Decreased Cardiac Output, A-Fib, Cardiac Arrhythmia, Dysrhythmia, Irregular Heart Rate, Cardiac Dysrhythmia, Risk for Stroke and Pulmonary Embolism. Positive study for DVT very helpful in establishing diagnosis and origin or PE, b. Increased physiologic dead-space ventilation, b. Pulmonary embolism-what you know may save your life. Carries unoxygenated blood to the lungs, 6. Increased pain, swelling, warmth, erythema of leg: seek emergency care, call 911, c. Chest pain, rapid pulse, sweating, anxiety, fainting, hemoptysis: seek emergency care, call 911, d. Unilateral paralysis, numbness, facial droop, vision or speech change, loss of coordination, change in mental status: seek emergency care, call 911, 1) Major: call 911 or go to emergency room, a. Vitamin K: can have a negative effect on warfarin, 1) Diet should be consistent and moderate, 2) Give list of foods that are moderate to high in vitamin K, a) Green leafy vegetables are high in vitamin K, b) Green tea and tobacco are very high in vitamin K and should be avoided, c. Maintain desired weight (BMI between 19 and 25), d. Check with health care provider before using any herbal remedies, a. When PE causes >50% pulmonary artery obstruction, severe pulmonary artery hypertension leads to distention of right ventricle and severe right heart failure, c. 80% of patients with known PE have abnormal ECHO, d. ECHO has been used to monitor improvement of obstruction, especially during treatment with fibrinolytic agents, C. Invasive Testing: pulmonary angiography, 1. Congestive heart failure is single most important condition predisposing to DVT/PE (Abrams, 1997), b. True. While history has long been filled with men and women providing care to injured soldiers and loved ones, the actual profession of nursing did not develop until the 19th century. Prevention of venous thromboembolism. Copyright © 2021 RegisteredNurseRN.com. The development of the profession was largely influenced by Florence Nightingale, who felt a strong conviction that God had called to her become a nurse. Jaff, M., McMurtry, M. S., Archer, S. L., Cushman, M., Goldenberg, N., Goldhaber, S. Z., … Zierler, B. K. (2011). Lytic agents have short half-life: discontinuation results in rapid cessation of lytic activity. Maintenance of activities of daily living or pre-illness level of function, d. INR goal: define and give expected range (usual 2 to 3), a. Tablet strength, color, how many, and how often to take, 2) Medical attention for new rash or significant bleeding, 1) No ASA unless prescribed by care provider, 2) Multiple drug and food interactions with warfarin, 3) Discuss any new OTC or prescription products prior to starting, d. Subcutaneous injection technique if self-administering heparin or LMWH, e. Discuss estrogen therapy risks with medical provider, b. Also, don’t forget to subscribe to our YouTube channel (RegisteredNurseRN). Elderly: hormone replacement therapy; safety issues: increased risk of falls, home environment, support systems, memory loss, increased bleeding risk; general health/nutritional status (may require a lower dose); use of alcohol, tobacco, and illicit drugs; polypharmacy/medications; prior episodes of DVT/PE; stroke/paralysis; surgery/trauma, A. Berg, D. E. (1992). Classic subjective symptoms in order of frequency (Thompson & Hales, 2004), b. Pleuritic chest pain, especially exacerbated by movement or breathing: 66%, a. Documented history of a pulmonary embolism, E. Physical Examination/Objective Findings, 1. Signs and symptoms variable, subtle, and nonspecific, a. during acute illness; then every 8 hours once stable, b. Assess feelings as patient verbalizes emotions, c. Note patient’s interactions with others, A. Identify key elements in educating the patient who is treated for pulmonary embolism. Changes in medication, diet, missed dose, X. Venous thrombosis: A multicausal disease. ), Pathophysiology: Clinical concepts of disease process (5th ed., pp. A positive venous ultrasound which demonstrates presence of deep vein thrombosis is very helpful in establishing diagnosis of PE and eliminates need for further invasive testing. Test your knowledge on the lab values you need to know for NCLEX with these quiz questions for nursing students! Our mission is to Empower, Unite, and Advance every nurse, student, and educator. Special coagulation studies, if necessary, 1. Clinical trial results. 90% from deep veins of legs as demonstrated by Virchow through dissection studies (Wheeler & Anderson, 1996), 2. allnurses is a Nursing Career, Support, and News Site. The Florence Nightingale Pledge, Composed by Lystra Gretter. Components and defects of the coagulation system. It is estimated that the overall financial burden of pulmonary embolism is over $1.5 billion/year in associated health care costs or $30,000 per incident whereas the preventative costs are only $3,000 per patient (American Thoracic Society, 2010). RN, 63(4), 59–62. A., Clagett, G. P., Pineo, G. F., Colwell, C. W., Anderson, F. A., Jr., & Wheeler, H. B. a. Dyspnea with tachypnea and labored respirations. Her ideas and devotion to nursing quickly spread to other countries, including the United States. Abrams, G. D. (1997). A pulmonary embolus is pulmonary vasculature that occurs from a fibrin or blood clot. ; Registered nurses (RNs): average RN salary of $71,000; average hourly wage of $34.14. Administration of oxygen and 1 mg of morphine sulfate. Medications to control/stabilize blood pressure, manage dysrhythmias, maintain normal volume status, C. Baseline Laboratory Values Prior to Initiation of Treatment, 1. Morris, C. S., Rogers, F. B., Najarian, K. E., Bhave, A. D., & Shackford, S. R. (2004). St. Louis, MO: Mosby. Mr. D. needs to be assessed for presence of anemia and platelet abnormality prior to anticoagulation to establish a baseline in case he should develop bleeding complications or platelet abnormality as a reaction to heparinization. Retrieved from cpmcnet.columbia.edu/texts/guide/hmg16_0007.html, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), emedicine.Medscape.com/article/419796-overview, www.thoracic.org/education/breathing-in-america/index.php, www.trialresultscenter.org/study7632-PEGASUS.htm, www.mayohealth.org/mayo/9701/htm/heparin.htm, www.mayohealth.org/mayo/9807/htm/pulmonary.htm, www.mayohealth.org/mayo/askphys/qa970604.htm, australianprescriber.com/magazines/vol21no3/vein_thrombosis, www.geneclinics.org/profiles/factor-v-leiden/details.html, cpmcnet.columbia.edu/texts/guide/hmg16_0007.html, Superficial Thrombophlebitis and Deep Vein Thrombosis, Anatomy and Physiology of the Vascular System, Upper Extremity Arterial Occlusive Disease, Renovascular Disease and Ischemic Nephropathy, Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE) in patients with contraindication or complication to anticoagulants, Prevention of PE in patients undergoing surgery, cancer, or trauma. Although true incidence of the disease is unknown because of low autopsy rate and lack of diagnoses, 94,000 cases of pulmonary embolism are identified annually (Heit et al., 2001). Author Information Current trends in vena caval filtration with the introduction of a retrievable filter at a level I trauma center.
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