Management of pulmonary embolism

Pulmonary embolism (PE) is a common condition with significant mortality and morbidity. Its occurrence frequently triggers referral to critical care services. Patients within critical care environments are also at elevated risk of developing venous thrombo-embolism and PE. This highlights the need for critical care clinicians to be confident in their approach to the patient with PE. Furthermore, the co-morbid conditions in this patient group may present additional challenges both in diagnosis (e.g. safe access to radiology) and management (e.g. relative contraindication to anticoagulation/thrombolysis in trauma or intracranial haemorrhage). This brief review summarizes the contemporary evidence base regarding both diagnosis and treatment strategies and draws upon this to suggest a simple algorithm for investigation, risk stratification and management, particularly tailored to patients within a critical care setting.