Pulmonary embolism in neurological and neurosurgical patients.

Pulmonary embolism is a serious problem in patients with lesions of the central nervous system, with a mortality rate estimated at 15% or higher. Early recognition of pulmonary embolism and institution of measures to prevent further embolic episodes are vital because mortality is frequently attributable to recurrent emboli. Anticoagulants and thrombolytic agents are contraindicated in some groups of patients with neurological and neurosurgical problems. In these patients, interruption of the inferior vena cava may be employed to prevent embolic episodes. Nursing management of the patient with pulmonary embolism includes measures to maintain adequate oxygenation and hemodynamic stability, alleviate apprehension, and prevent recurrent emboli.