Pulmonary Embolism; Roadside to Resus

Pulmonary emboli represent a critical diagnostic and therapeutic challenge in emergency medicine, requiring precise risk stratification to guide clinical management. Pathophysiologically, these clots obstruct pulmonary blood flow, increasing right ventricular afterload and potentially leading to hemodynamic collapse. Diagnostic accuracy relies on tools like the PERC rule and Wells score to determine pre-test probability, followed by D-dimer testing or imaging such as CTPA. Treatment strategies vary significantly based on severity: non-massive cases are typically managed with anticoagulation, while massive, hemodynamically unstable presentations may necessitate aggressive interventions like thrombolysis or embolectomy. Despite the high mortality associated with massive PE and cardiac arrest, evidence supporting specific thrombolytic protocols remains limited, emphasizing the need for individualized, evidence-based care and careful consideration of patient-specific risk factors during the diagnostic process.