Читать книгу Clinical Cases in Paramedicine - Группа авторов - Страница 103

RR: 30 bpm

HR: 128 bpm

BP: 88/60 mmHg

SpO₂: unable to obtain

Blood glucose: not repeated

Temperature: not repeated

GCS: 15/15

12 lead ECG: sinus tachycardia with right bundle branch block (RBBB)

1  What is the most common ECG finding in PE? What other ECG changes are associated with PE? The most common ECG finding in PE is sinus tachycardia. PE can cause any of the following ECG changes:T‐wave inversion.New‐onset atrial fibrillation.Right bundle branch block.Right axis deviation.S1Q3T3 (this is a specific pattern that is seen rarely in PE):S waves in lead I.Q waves in lead III.T‐wave inversion in lead III.

2  Explain why females taking the oral contraceptive pill are at greater risk of developing a PE. Virchow’s triad explains the three broad categories that play a part in thrombus formation:Hypercoagulability.Hemodynamic changes (stasis, turbulence).Endothelial injury/dysfunction.Taking contraceptive drugs that contain oestrogen can actually change the constitution of the blood, increasing plasma and other clotting factors. This causes the woman to be in a hypercoagulative state, increasing the risk of developing DVT/PE.