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How is pulmonary embolism managed? The first step is to assess the stability of a patient. In stable patients with minimal risk factors and no comorbid medical conditions, anticoagulation medications can be started in the emergency room and the patient can then be discharged home for further outpatient management. However, if a patient is deemed high risk and the patient has hemodynamic changes of a high heart rate, low blood pressure, low oxygen saturation, and labs suggestive of cardiac damage, than inpatient hospitalization is required. In the highest risk patients with significant comorbid conditions, an ICU stay can be necessary.