INDEX

Pulmonary Embolism

PTE Work-up Algorithm

The following algorithm may be helpful for PTE work-ups:

 

PE Response Team (PERT)

Activation Criteria

  • Diagnosed PTE or highly suspected PTE

  • PLUS features of a massive PTE

    • HD instability

    • Rapidly accelerating respiratory failure

  • …or features of a submassive PTE

    • Trop/BNP elevation

    • Right heart strain

    • RV/LV ratio 1:1 on CT

Activation Process

  • Call the operator "0" and ask for the "PE Response Team".

  • It will batch page the MICU and CCU fellows and PERT attending on call.

  • The goal is to have care recommendations from the team within 1 hour.

 

Follow-Up For Discharged Patients

Dr. Jori May with Hematology has been working on a pathway to rapidly follow up with patients who have low-risk pulmonary embolism not requiring admission. If you take care of a patient in any of our emergency departments that you diagnose with PE that you feel is low-risk, we have a pathway in place to have them follow up with Dr. May within 1 week.

  1. Ensure that the patient will leave with a reliable plan to get anticoagulation for at least 30 days. Social work can assist with supplying coupons for 30 day supplies for several of the NOAC’s (Dr. May prefers Apixaban).

  2. Use the “UED Low Risk Pulmonary Embolism” PowerPlan that includes the prescription and Post ED Follow-Up order.

These patients will obtain follow up in Dr. May’s clinic within 1 week of ED discharge and have a patient navigator reach out to them.

KEYWORDS: PERT, pulmonary embolism, PTE, PE