Chart — Respiratory
Pulmonary Embolism Recognition Chart
PE hides as “sudden, unexplained dyspnea” in an at-risk patient. This chart lines up the risk, the classic picture, the red flags that mean massive PE, and what to do first.
Educational use only. PE is a life-threatening emergency. This chart is an educational recognition aid; treatment is provider-directed. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Recognize It Fast
| Step | What to look for / do |
|---|---|
| Who's at risk (Virchow) | Stasis (immobility, surgery, long travel), hypercoagulability (cancer, pregnancy, estrogen), endothelial injury (trauma, central lines); most PEs come from a DVT |
| Classic presentation | SUDDEN dyspnea (most common), pleuritic chest pain, tachypnea, tachycardia, hypoxia, anxiety/impending doom, cough ± hemoptysis |
| Source clue | Unilateral leg swelling, pain, warmth (DVT) |
| Massive-PE RED FLAGS | Hypotension/obstructive shock, distended neck veins, signs of right-heart failure, syncope, severe hypoxia |
| First nursing actions | Oxygen, HOB up, continuous monitor (SpO₂/ECG/BP), IV access, notify provider/rapid response, anticipate CTA + anticoagulation (± thrombolytics if massive) |
Exam Traps
- ✦Think PE for any SUDDEN, unexplained dyspnea or hypoxia in an at-risk patient — a normal exam doesn't rule it out.
- ✦Classic combo: sudden dyspnea + pleuritic chest pain + tachycardia + hypoxia.
- ✦Massive PE red flags: hypotension, JVD, RV failure, syncope → may need thrombolytics.
- ✦First actions: oxygen, HOB up, monitor, IV access, notify provider/rapid response.
- ✦Prevention is nursing care: early ambulation, SCDs, pharmacologic VTE prophylaxis.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Association for Respiratory Care (AARC) · GOLD (COPD) / ATS / CHEST. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →