Abstract: To summarize the emergency nursing care for a patient with pulmonary embolism due to subcutaneous bleeding，who has insufficient anticoagulation and thrombus detachment in the lower extremities leading to worsening acute pulmonary embolism. Nursing points：dynamic assessment of patients’ pulmonary embolism risk stratification and adoption of personalized nursing measures，dynamic adjustment of anticoagulant drug dosage and close observation of bleeding，strengthening of observation and nursing care during inadequate anticoagulation to prevent dislodgement of lower limb thrombus. With the participation of the rapid response team，the patient was transferred to the intensive care unit for further treatment within half an hour. After active resuscitation，the patient was transferred back to the Department of Respiratory Medicine nine days later，and he was improved and discharged.

Key words: Pulmonary Embolism, Hemorrhage, Anticoagulation, Insufficient Anticoagulation, Critical Care Nursing