Emma Geea, Lara Robertsa Roopen Aryaa Vicki Tsianakasb
Highlighting the quality of care of patients aged 16yrs+ who had a PE, who either presented to hospital or who developed a PE whilst an inpatient for another condition.
526 cases of PE were reviewed.
Delays were recorded throughout the process of care with recognition, investigations and treatment the commonest reasons
Principal recommendation 1:
Give an interim dose of anticoagulant to patients suspected of having an acute pulmonary embolism (unless contraindicated) when confirmation of the diagnosis is expected to be delayed by more than one hour. The anticoagulant selected, and its dose, should be personalised to the patient.
Action: For query / suspected PE please flag to prescribers the need for therapeutic anticoagulation (unless contraindicated) if it is anticipated it will take or has already taken more than an hour to confirm diagnosis.
Full report, summary and implementation tools can be found at:
Simon Noble MBBS, MD, FRCP Annmarie Nelson PhD Jill Scott RN Anne Berger RN Karen Schmidt RN Parinita Swarnkar Agnes Lee MD, MSc, FRCPC
Summary of consensus statements agreed at an Expert Working Group meeting to identify actions for improvements in the management of patients at risk of recurrent VTE.
Ricardo Oliveira, Raj K. Patel, Chris Taylor, Julia Czuprynska, Roopen Arya, Lara N. Roberts
Ann Hutchinson, Sophie Rees, Annie Young, Anthony Maraveyas, Kathryn Date and Miriam J Johnson
Ingrid Pabinger, Nick van Es, Georg Heinze, Florian Posch, Julia Riedl, Eva-Maria Reitter, Marcello Di Nisio, Gabriela Cesarman-Maus, Noémie Kraaijpoel, Christoph Carl Zielinski, Harry Roger Büller, Cihan Ay
The Lancet July 2018
Evensen LH, Isaksen T, Hindberg K, Braekkan SK, Hansen JB
Dalia M. Dawoud, David Wonderling, Jessica Glen, Sedina Lewis Xavier Griffin, Beverley J. Hunt, Gerard Stansby, Michael Reed, Nigel Rossiter, Jagjot Kaur Chahal, Carlos Sharpin and Peter Barry
The benefits of pay-for-performance schemes in improving the quality of care remain uncertain. There is little information on the effect of removing incentives from existing pay-for-performance schemes.
Cancer-associated thrombosis has an impact on patients’ lives. Many cancer patients do not know that they are at increased risk of getting thrombosis. Education for patients and clinicians should be part of routine care and further work is needed to make this patient priority equal to that of other cancer complications such as spinal cord compression or neutropenic sepsis.
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Severely injured patients often progress from early hypocoagulable to normal and eventually hypercoagulable states, developing increased risk for venous thromboembolism (VTE). Prophylactic anticoagulation can decrease this risk, but its initiation is frequently delayed for extended periods due to concerns for bleeding. To facilitate timely introduction of VTE chemoprophylaxis, we characterized the transition from hypo- to hypercoagulability and hypothesized that trauma-induced coagulopathy (TIC) resolves within 24 hours after injury.