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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, April 22, 2019

PE ambulatory care

St. Emlyn´s - April 20, 2019 - By Dan Horner 
...I was asked principally to talk about the new British Thoracic Society guidelines for the outpatient management of pulmonary embolism​, but thought I would add a dusting of NICE guideline revision and a few cherries of recent literature, which should all directly impact how we provide care to these patients....
I am sure many of you have been ambulating PE for years. But these guidelines and this recent literature provide support to some of the greyer areas and create national templates to support delivery of care that you know is right, but have been struggling to deliver. I think the key areas are as follows:
  1. There is now clear guidance supporting the use of risk scores and which ones are preferable
  2. Clear exclusion criteria to defend a decision to refer for inpatient care
  3. First guideline to advocate a single DOAC pathway as an option; this will help you with your medicines management committees.
  4. First guideline to even suggest that ambulating pregnant patients is an option, although complex as we have seen.
  5. First guideline to provide a template for follow up care
Quality standards are coming that will lend further support to development in this area. Need buy in, funding, staff or resources to deliver any of the above? Lever this national guidance and quality standards to get it."