Know Your Guidelines – Thrombolysis for Pulmonary Embolism

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Guideline Knowledge Check, Medical News

Emergency Medicine Guidelines Knowledge Check Pneumonia

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Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

Based on an assigned article from the 2019 ABEM Lifelong Learning & Self-Assessment (LLSA) list…

Have the indications for treating pulmonary embolism with thrombolysis changed since ABEM’s 2017 and 2018 reading assignments?

Yes or No?

Try this review question and find out if you're following the most current guideline.

LLSA Review Question

A 32-year old man presents from a rehabilitation facility with acute dyspnea and mild hypoxia. He is wheelchair bound secondary to amylotrophic lateral sclerosis. He has no other comorbidities. A workup during his current presentation reveals a submassive pulmonary embolism (PE). The patient is overall hemodynamically stable, although bedside ultrasound confirms right heart strain and he has a 5 minute episode of transient hypotension.

Which of the following is the best treatment option in this patient?

Answer Options:

Full-dose systemic thrombolysis

Half-dose systemic thrombolysis, incorporating shared decision making with the patient when possible

Surgical thromboembolectomy


Answer Explanation & References:

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With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

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About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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