Case of the Week 4 – PE and thrombolysis

CHFT Case of the Week 4 – download for links

CHFT Case of the Week 4


Case of the week this week explores diagnosis and initial management of PE in the ED – specifically focusing on the tricky group of ‘intermediate risk’ patients with significant PE but are haemodynamically stable

One comment

  1. jack long says:


    RV dilation –

    Wells score –

    PERC Score –

    EMBeds PE page with pregnancy link inside –

    ESC guidance (section 6 relating to initial therapy options) –

    Review of initial therapy options and pharmacokinetics (of relevance look for ‘Intermediate risk Pulmonary Embolism’ near the bottom) –

    Timing of death or instability of patients presenting to ED with PE –

    The last link really surprised me – I always considered thrombolysis an ‘immediate’ intervention and if people remained stable in the early phase, once the LMWH kicked in, they would generally remain stable. This paper suggests that is not the case and highlights the need for close monitoring and constant re review of these patients as thrombolysis may be indicated many days down the line even after multiple doses of LMWH.

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