Some Pulmonary Embolism Patients Can Be Treated at Home

MedicalResearch.com Interview with:

Joseph Bledsoe MD, FACEP Clinical Assistant Professor of Emergency Medicine Stanford Medicine Director of Research Department of Emergency Medicine Intermountain Medical Center Murray, UT 84157

Dr. Bledsoe

Joseph Bledsoe MD, FACEP
Clinical Assistant Professor of Emergency Medicine
Stanford Medicine
Director of Research
Department of Emergency Medicine
Intermountain Medical Center
Murray, UT 84157

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with blood clots in the lungs (pulmonary embolism) (PE) are routinely admitted to the hospital for blood thinning medications in the United States. However, evidence from other countries has shown that with appropriate risk stratification patients may be safe for outpatient treatment for their PE.

Our study is the largest prospective management study in the US to evaluate home treatment of patients with acute pulmonary embolism. We enrolled 200 patients and after risk stratification with the PE severity index score, leg ultrasounds and echocardiograms performed in the emergency department, patients were treated with blood thinning medications at home with routine outpatient follow up.

During the 90 day follow up period we found only one patient suffered a bleeding event after a traumatic injury, without any cases of recurrent symptomatic blood clots or death.  Continue reading

Patients Who Leave the ER Prematurely: They Are Not All the Same

MedicalResearch.com Interview with:
Jessica Moe MD, MA, PGY4 FRCPC Emergency Medicine
MSc (Candidate) Clinical Epidemiology
RCPS Emergency Medicine Residency Program
University of Alberta
Edmonton, Alberta

Medical Research: What is the background for this study? What are the main findings?

Dr. Moe: Patients who leave the emergency department (ED) prior to completing their care account for a substantial number of annual visits; some of these patients are at high medical risk. We used the National Hospital Ambulatory Medical Care Survey from 2009-2011 to examine a nationally representative sample of patients who left the ED prior to completing care.

Our work suggests that, among patients who leave the ED prematurely, the degree of medical risk may be related to whether or not these patients saw a medical professional prior to leaving the ED. Patients who leave prior to medical evaluation are generally younger and present with lower acuity visits, whereas patients who leave after medical evaluation tend to be older, are more likely to arrive by ambulance and have higher acuity visits.

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