Massive Pulmonary Embolism

Key Priorities

• Recognise sudden desaturation and hypotension

• Initiate resuscitation and consider thrombolysis

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🧠 Team Actions

Role	Task
Team Leader	Lead diagnosis + direct resuscitation
Airway Manager	Oxygenation, possible intubation
Circulation	Secure access, start adrenaline/fluids

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🧭 Management Algorithm

1. Sudden hypotension/desaturation + raised EtCO₂ gradient

2. Call for help, 100% O₂

3. Support BP: adrenaline infusion

4. Echo for RV dilation if available

5. Consider thrombolysis (alteplase 50mg IV bolus in arrest)

6. ECMO discussion if ongoing collapse

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🔄 Ideal Crisis Flow

      Suspected Intraoperative PE Collapse
                    ↓
       Oxygen + Vasopressors + Echo if Possible
                    ↓
         Consider Thrombolysis or ECMO
                    ↓
                ICU + Imaging Follow-Up