BTS Guideline for the initial outpatient management of pulmonary embolism (PE)

British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism

Target audience for the guideline
This guideline is aimed at clinicians, in particular physicians, clinical nurse specialists and advanced nurse practitioners, at all levels of seniority delivering emergency, acute, ambulatory and inpatient care who are involved in the management of acute PE. The main specialties referring to the guidance are likely to be acute, emergency, general (internal) and respiratory medicine. It is also designed to inform general practitioners involved in the delivery of ambulatory care or thrombosis pathways. This document may also be used by healthcare commissioners and hospital management to ensure appropriate staffing and resourcing of ambulatory care facilities to integrate PE management into ambulatory care pathways.

Scope of the guideline
The guideline covers:
- adults (≥16 years) with suspected and confirmed acute PE;
- haemodynamically stable PE;
- use of DOACs in relation to suspected PE and outpatient management;
- risk stratification for identifying patients suitable for outpatient management or early discharge;
- special subgroups of patients (pregnant patients, those with cancer and intravenous drug abusers).

The guideline does not cover:
- the diagnostic algorithm for PE;
- evidence for cancer screening;
- detailed comparisons of anticoagulant drugs;
- who should be treated and not treated, specifically how to manage subsegmental PE;
- duration of anticoagulation and thrombophilia investigations.


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