Patients
What is a Pulmonary Embolism?
Who is at Risk?
What are the symptoms of PE?
What tests may be performed?
PE Treatments
What can happen if pulmonary embolism is not treated?
Other Sources for Information
Health Care Provider (HCPs)
Diagnosing and Treating
Approach to a Patient
Flow Chart
Identify patients
Patient Assessment
Optimal Duration of Anticoagulation
Hypercoagulable testing
Anticoagulation prescriptions
Cost reduction strategies
Patient Handout
Outpatient follow-up
References and Bibliography
Patient Assessment
PULMONARY EMBOLISM
Patient Assessment
Step 1 of 5
20%
PESI Class of >II or sPESI score >0.
*
YES
NO
Evidence of new right ventricular strain
*
noted on CTPA or echocardiogram. or RV dilation on echocardiography or CTPA, or RV systolic dysfunction on echocardiography
YES
NO
Elevated cardiac biomarkers
*
i.e. above normal values of BNP, NT pro-BNP, troponin I or troponin T
YES
NO
Hemodynamic instability
*
YES
NO
Severe hypoxemia
*
(pulse oximetry < 90% on room air)
YES
NO
Renal failure
*
(creatinine clearance < 30 mL/min) or severe liver impairment
YES
NO
Active bleeding or high risk of bleeding
*
YES
NO
Currently pregnant
*
YES
NO
Morbid obesity
*
YES
NO
Patient requires intravenous opioid treatment for pain control
*
YES
NO
History of heparin- induced thrombocytopenia
*
YES
NO
Any barriers to treatment adherence or follow-up
*
including cost of medication, living conditions and transportation for follow up
YES
NO
Inability to walk for 5 minutes without dyspnea and/or hypoxia prior to discharge
*
YES
NO
Presence of other diagnosis requiring hospitalization
*
YES
NO
Identify patients with PE who can be treated as outpatient or early discharge from hospital
Identify optimal duration of anticoagulation