Massive PE

Question 1

1. Lovenox

Answer 1

1 mg/kg sub-q (if not using heparin)

Question 2

2. Heparin UF

Answer 2

80 U/kg bolus (no max) then 18 U/kg/hr drip

Question 3

3. tPA

Answer 3

a. a. 100 mg (first 10 mg over 10 min then 90 mg over 2 hours)
b. 50 mg over 2 minutes if suspect PE as cause of cardiac arrest, continue CPRx15 min and repeat dose if necessary

Question 4

When should you get a head CT prior to administering tPA

Answer 4

Pt is a poor historian or you are uncertain of possible ICH