Massive pulmonary embolism
Educational use only. Not clinically reviewed57-year-old man for Refractory pulmonary embolism rescue. About 9 simulated minutes.
What you will practise
- Recognize refractory PE shock and activate PERT plus ECMO-capable rescue.
- Integrate fixed PE, RV, ventilation, perfusion, and alternate-cause findings without delaying rescue for repeated diagnosis.
- Record RV-sensitive perfusion, oxygenation, ventilation, rhythm, and anticoagulation review without blind fluid loading.
- Activate resource-dependent VA-ECMO candidacy and cannulation pathways as a bridge for Category E2 refractory shock.
- Reassess perfusion and oxygenation after the authored bridge while individualizing any additional reperfusion strategy.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Creager MA, Barnes GD, Giri J, et al. 2026 Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults. Circulation. 2026;153:e977-e1051.
- Lorusso R, Shekar K, MacLaren G, et al. ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients. ASAIO J. 2021;67:827-844.
- Monnet X, Messina A, Greco M, et al. ESICM guidelines on circulatory shock and hemodynamic monitoring 2025. Intensive Care Med. 2025;51:1971-2012.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.