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Pulmonary embolism management in the emergency department
  1. Philippa Serebriakoff1,
  2. John Cafferkey1,
  3. Kerstin de Wit2,
  4. Daniel E Horner3,4,
  5. Matthew J Reed1,5
  1. 1Emergency Medicine Research Group Edinburgh (EMERGE), NHS Lothian, Edinburgh, UK
  2. 2Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
  3. 3Emergency Department, Salford Royal NHS Foundation Trust, Salford, UK
  4. 4Division of Infection, Immunity and Respiratory Medicine, The University of Manchester, Manchester, UK
  5. 5Acute Care Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Matthew J Reed, Emergency Medicine Research Group Edinburgh (EMERGE), NHS Lothian, Edinburgh, UK; mattreed{at}ed.ac.uk

Abstract

Pulmonary embolism (PE) can present with a range of severity. Prognostic risk stratification is important for efficacious and safe management. This second of two review articles discusses the management of high-, intermediate- and low-risk PE. We discuss strategies to identify patients suitable for urgent outpatient care in addition to identification of patients who would benefit from thrombolysis. We discuss specific subgroups of patients where optimal treatment differs from the usual approach and identify emerging management paradigms exploring new therapies and subgroups.

  • pulmonary embolism
  • thrombo-embolic disease
  • management
  • emergency care systems
  • thrombolysis

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Footnotes

  • Handling editor Richard Body

  • Twitter @mattreed73

  • Contributors PS, JC and MJR devised the concept and planned the review. PS and JC drafted the manuscript. KdW, DEH and MJR provided critical review and redrafted the work. MJR is guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. No funding was used for the preparation of this manuscript. DEH is currently appointed as professor of the Royal College of Emergency Medicine and has specific NIHR funding relevant to a thrombosis research project (NIHR127454). MJR is supported by an NHS Research Scotland Career Researcher Clinician award.

  • Competing interests DEH was a topic expert for NICE NG158 and QS201, regarding the diagnosis and management of venous thromboembolic disease and venous thromboembolism in adults, respectively. DEH was also a coauthor on the BTS guidelines for the outpatient management of PE and the accompanying national quality standards. JC, PS, KdW and MJR have no conflicts of interest to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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