A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel
Abstract The outpatient treatment of select emergency department patients with acute pulmonary embolism (PE) or deep vein thrombosis (DVT) has been shown to be safe, cost effective and associated with high patient satisfaction. Despite this, outpatient PE and DVT treatment remains uncommon. To addre...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-12-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12588 |
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| author | Christopher Kabrhel David R. Vinson Alice Marina Mitchell Rachel P. Rosovsky Anna Marie Chang Jackeline Hernandez‐Nino Stephen J. Wolf |
| author_facet | Christopher Kabrhel David R. Vinson Alice Marina Mitchell Rachel P. Rosovsky Anna Marie Chang Jackeline Hernandez‐Nino Stephen J. Wolf |
| author_sort | Christopher Kabrhel |
| collection | DOAJ |
| description | Abstract The outpatient treatment of select emergency department patients with acute pulmonary embolism (PE) or deep vein thrombosis (DVT) has been shown to be safe, cost effective and associated with high patient satisfaction. Despite this, outpatient PE and DVT treatment remains uncommon. To address this, the American College of Emergency Physicians assembled a multidisciplinary team of content experts to provide evidence‐based recommendations and practical advice to help clinicians safely treat patients with low‐risk PE and DVT without hospitalization. The emergency clinician must stratify the patient's risk of clinical decompensation due to their PE or DVT as well as their risk of bleeding due to anticoagulation. The clinician must also select and start an anticoagulant and ensure that the patient has access to the medication in a timely manner. Reliable follow‐up is critical, and the patient must also be educated about signs or symptoms that should prompt a return to the emergency department. To facilitate access to these recommendations, the consensus panel also created 2 web‐based “point‐of‐care tools.” |
| format | Article |
| id | doaj-art-dd7d196ecaea4036a45dd7abfb2484cf |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-dd7d196ecaea4036a45dd7abfb2484cf2025-08-20T03:09:59ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522021-12-0126n/an/a10.1002/emp2.12588A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panelChristopher Kabrhel0David R. Vinson1Alice Marina Mitchell2Rachel P. Rosovsky3Anna Marie Chang4Jackeline Hernandez‐Nino5Stephen J. Wolf6Department of Emergency Medicine, Center for Vascular Emergencies Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine, Kaiser Permanente Division of Research and the CREST Network, Oakland, CA Kaiser Permanente Roseville Medical Center Roseville California USADepartment of Emergency Medicine, Richard L. Roudebush VAMC Indiana University School of Medicine Indianapolis Indiana USADivision of Hematology Department of Medicine Massachusetts General Hospital, Harvard Medical School Boston Massachusetts USADepartment of Emergency Medicine Thomas Jefferson University Hospitals Philadelphia Pennsylvania USADepartment of Emergency Medicine Indiana University School of Medicine Indianapolis Indiana USADepartment of Emergency Medicine Denver Health and University of Colorado School of Medicine Denver Colorado USAAbstract The outpatient treatment of select emergency department patients with acute pulmonary embolism (PE) or deep vein thrombosis (DVT) has been shown to be safe, cost effective and associated with high patient satisfaction. Despite this, outpatient PE and DVT treatment remains uncommon. To address this, the American College of Emergency Physicians assembled a multidisciplinary team of content experts to provide evidence‐based recommendations and practical advice to help clinicians safely treat patients with low‐risk PE and DVT without hospitalization. The emergency clinician must stratify the patient's risk of clinical decompensation due to their PE or DVT as well as their risk of bleeding due to anticoagulation. The clinician must also select and start an anticoagulant and ensure that the patient has access to the medication in a timely manner. Reliable follow‐up is critical, and the patient must also be educated about signs or symptoms that should prompt a return to the emergency department. To facilitate access to these recommendations, the consensus panel also created 2 web‐based “point‐of‐care tools.”https://doi.org/10.1002/emp2.12588deep vein thrombosisoutpatientpulmonary embolismtreatmentvenous thromboembolism |
| spellingShingle | Christopher Kabrhel David R. Vinson Alice Marina Mitchell Rachel P. Rosovsky Anna Marie Chang Jackeline Hernandez‐Nino Stephen J. Wolf A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel Journal of the American College of Emergency Physicians Open deep vein thrombosis outpatient pulmonary embolism treatment venous thromboembolism |
| title | A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel |
| title_full | A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel |
| title_fullStr | A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel |
| title_full_unstemmed | A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel |
| title_short | A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel |
| title_sort | clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis results from a multidisciplinary consensus panel |
| topic | deep vein thrombosis outpatient pulmonary embolism treatment venous thromboembolism |
| url | https://doi.org/10.1002/emp2.12588 |
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