administer morphine 10 mg i.v., especially if patient in pain
start heparin
low molecular weight heparin is as effective as unfractionated heparin (1)
give patient thrombo embolism deterrent stockings to wear
patients have and require high right heart filling pressures; treatment with diuretics and vasodilators is deleterious
once stabilised on heparin, commence warfarin treatment; give loading dose of 10 mg daily for two days; adjust third daily dose according to the patient's INR. Aim to maintain the INR at 2.5-3.5X normal. In general, treatment with warfarin is for 6 months for a first PE (1)
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