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The Resus Room

Pulmonary Embolism; Roadside to Resus

The Resus Room

Simon Laing

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

4.8678 Ratings

🗓️ 16 September 2024

⏱️ 64 minutes

🧾️ Download transcript

Summary

PE’s (or Pulmonary Emboli) are a key part of Emergency Care, something that many of us will consider as a differential diagnosis multiple times of a daily basis, in a similar way to acute coronary syndrome, so we need to be absolute experts on the topic!

A PE normally occurs when a Deep Vein Thrombosis shoots off to the pulmonary arterial tree, occurring in 60-120 per 100,000 of the population per year

The inhospital mortality is 14% and the 90 day mortality is around 20%. But this is proportional to its size, and risk stratifying PE’s once we’ve got the diagnosis is really important.

PE is a real diagnostic challenge and less than 1 in 10 who are investigated for a PE end up with the diagnosis, so knowing the risk factors, associated features and thresholds for work up are really important.

There are some key concepts in risk stratification and particularly in test thresholds that we’ll cover in this episode that are applicable to all of our practice…..we’re excited! Getting these right helps us to avoid missing the diagnosis and equally importantly ensure we aren’t ‘over testing’ & ‘over diagnosing’ because investigation and treatment for a PE isn’t without it’s own risks.

In the episode we’ll talk in depth about factors associated with presentation, risk factors, investigations and finally onto treatments, covering the whole spectrum from low risk PE’s up to those with massive PE’s and cardiac arrest. The evidence base behind the work up and treatments is truly fascinating and we hope you find this episode as eye-opening as we did to prepare for!

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

Transcript

Click on a timestamp to play from that location

0:00.0

Welcome to the Recess Room Podcast.

0:03.0

Five, four, three, two, one, fire.

0:13.0

So hi, and welcome back to the Recess Room podcast.

0:15.7

I'm Simon Lang.

0:17.0

I'm Rob Fenwick, and I'm James Hates.

0:19.0

And we're back with another roadside to recessus as we traditionally do with a whopping topic on PEs. Yeah, that's right, pulmonary emberlis and we've just about remembered how to set up our microphones and computers for this. It's only taken about 30 minutes to get in the right setting. And it is pretty ironic that we're talking about

0:37.8

PEs today. I mean, I hope you boys have got your compression stockings on because this is

0:42.7

mighty, mighty episode coming up. Yeah, absolutely. I mean, I'm not saying we've been dodging

0:47.9

this one, but essentially we have like a teenager dodging their homework. It's a big topic.

0:53.2

It's a big topic, It's a big topic.

0:54.7

But this is,

0:55.4

it's a brilliant.

0:57.5

And I can honestly guarantee,

0:59.9

I think we are in for an absolute treat of an episode here, chaps.

1:01.2

We absolutely are.

1:02.9

So before we get into it,

1:05.6

a huge thanks to Zol Medical Corporation,

1:07.3

who collaborate with us on the podcast and make this all free open access and available to you. And the tickets have

1:12.6

gone out for our Zol event on October the 2nd. So we look forward to seeing many of you there

1:18.3

and you can see how bad we are live in person and without the edit. So without further ado,

1:26.0

let's get on to something that can be edited and start off with pulmonary embelly.

1:33.3

Okay, well, P.E.'s or POMonary emboli are a key part of emergency care and something that many of us will consider as a differential diagnosis multiple times on a daily basis, probably in the

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