PE; the latest controversy

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 10 November 2016

⏱️ 20 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

It's never long before the topic of pulmonary embolism makes it back into the controversial lime light and a recent paper on the association of PE with syncope is the lastest reason.

The PESIT trial, just published in the New England Journal of Medicine certainly grabs your attention when you read the abstract, with the implication that PE's are a major and hugely missed cause of the presentation of syncope. It also highlights a diagnostic work up that consists of blanket Well's scoring +/- d-dimer to decide who should be worked up further for the potential diagnosis, for every single patient presenting with syncope, including those with no appropriate symptoms or signs!

As always to read the abstract and draw a conclusion is to fall at the first hurdle, so take a listen to the podcast as we dive a bit deeper into the paper and topic, and of course make sure you take a look at the paper yourself and see what you make of the headline grabbing article

Enjoy!

References and Further Reading

Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope. Prandoni P. N Engl J Med. 2016

Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients. Schultz DJ.J Trauma. 2004 Apr

Prospective evaluation of unsuspected pulmonary embolism on contrast enhanced multidetector CT (MDCT) scanning. Ritchie G. Thorax. 2007 Jun.

EM Nerd-The Case of the Incidental Bystander

JC: Prevalence of PE in patients with syncope. St.Emlyn’s

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.0	So hi and welcome back to the recess room podcast.
0:15.0	I'm Simon Lang and I'm Rob Fenwick.
0:18.0	And this is an absolute gem of an episode.
0:22.8	So important, in fact, I've left the X-Factor results.
0:26.4	I've got no idea who's been voted off just to come and record this with Rob.
0:31.2	My word. And for those of you that don't know, Simon, that is quite a feat.
0:33.9	I mean, that is incredible. You are a big X-Factor fan.
0:37.3	I wouldn't say it's a highlight of the week, but it's not far off, actually.
0:41.7	Top three. Right, Rob. What are we talking about tonight, then?
0:47.0	Well, don't know if you're aware of this. There's a little bit of controversy around PE.
0:51.5	PE and controversy? That is remarkable.
0:55.0	Yeah, Pullman-Reamblese.
0:56.0	Indeed, I know.
0:58.0	Incredible.
0:59.0	And there was a little paper.
1:00.0	I don't know if you caught any of it on social media.
1:02.0	It was called the PE sit paper.
1:04.0	And it caused quite a stir, shall we say.
1:07.0	So we're going to run through that? We are indeed and we're going to have a look through the paper to start with
1:13.1	and then we're going to have a little discussion around
1:14.9	why or why not this is relevant and why or why not
	...

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