Optimizing Management of Pulmonary Embolism Patients during a Code Scenario

Enhancing bubble study contrast by adding a little blood or propofol significantly improves visibility. When coding a PE patient, administering the full 100mg of alteplase is tempting. Using epinephrine cautiously and simultaneously starting an infusion can be effective, although providing vigorous CPR and extending the duration to 60-90 minutes may be necessary due to poor cardiac output. Intubation should avoid excessive positive pressure, and pulmonary-based dilators can be considered. In these cases, CPR may need to be more prolonged than usual to enhance clot breakdown and patient outcome.