Massive Pulmonary Embolism

Key Priorities

  • Recognise sudden desaturation and hypotension

  • Initiate resuscitation and consider thrombolysis

🧠 Team Actions

Role

Task

Team Leader

Lead diagnosis + direct resuscitation

Airway Manager

Oxygenation, possible intubation

Circulation

Secure access, start adrenaline/fluids

🧭 Management Algorithm

  1. Sudden hypotension/desaturation + raised EtCOâ‚‚ gradient

  2. Call for help, 100% Oâ‚‚

  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

🔄 Ideal Crisis Flow

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

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