The Clot Thickens: Outpatient Management of ED Patients with Pulmonary Embolism & NSAIDs and OACs in Atrial Fibrillation


Jonathan Gravel and Peter Reardon host this week’s episode of The Rounds Table. Together they cover outpatient management of Emergency Department (ED) patients with pulmonary embolism and combining NSAIDs and oral anticoagulants in patients with atrial fibrillation.

Peter shares a post-hoc analysis of NSAIDs in the RE-LY (Randomized Evaluation of Long Term Anticoagulant Therapy) trial which compared dabigatran and warfarin in patients with atrial fibrillation. The analysis evaluated the association of NSAID use with risk of major bleeding, stroke, and hospitalization.

Next, many low risk patients identified with pulmonary embolism in the ED are hospitalized for treatment. Jonathan covers a trial which aimed to identify which patients diagnosed in the ED setting could safely forgo hospitalization and be treated as outpatients.

Finally, the Good Stuff segment. Peter shares an article on a new way to think about conflicts of interest in medicine. Jonathan shares a Healthy Debate article on cellphones used by hospital staff for personal reasons.                               

If you like what you hear, rate us on iTunes! Chat with us on Twitter @roundstable and tweet at Jonathan @gravel_jon.

The Papers

1. Outpatient PE Management: http://annals.org/aim/article-abstract/2714293/increasing-safe-outpatient-management-emergency-department-patients-pulmonary-embolism-controlled?doi=10.7326%2fM18-1206

2. NSAIDs, OACS, and afib: https://www.sciencedirect.com/science/article/pii/S0735109718348265?via%3Dihub

Good Stuff

1. Conflicts of Interest: https://www.nytimes.com/2015/09/01/upshot/a-new-way-to-think-about-conflicts-of-interest-in-medicine.html

2. Cellphones in the Hospital: https://healthydebate.ca/2018/11/topic/cellphones-in-the-hospital

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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