This episode reviews the highlights from the recent ACEP clinical policy on acute VTE management in the ED.


https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_148_0_Final_Cut.m4a



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Tags: Deep Venous Thrombosis, DVT, PE, Pulmonary Embolism, VTE





Show Notes
Take Home Points


The PERC risk stratifies low risk PE patients (~10%) to a level low enough (1.9%) as to obviate the need for additional testing.
Age-adjusted D-dimers are ready for use and it doesn’t matter if your assay uses FEU (cutoff 500) or DDU (cutoff 250). For FEU use an upper limit of 10 X age and for DDU use an upper limit of 5 X age.
For now, subsegmental PEs should continue to routinely be anticoagulated even in the absence of a DVT. Keep an eye out for more research on this area.
Although outpatient management of select PE patients (using sPESI or Hestia criteria) may be standard practice, the evidence wasn’t strong enough for ACEP to give it’s support
Patients with DVT can be started on a NOAC and discharged from the ED

[caption id="attachment_7115" align="aligncenter" width="501"] sPESI Tool (MDCalc.com)[/caption]

[caption id="attachment_7114" align="aligncenter" width="508"]