Serious Diseases: Outpatient Treatment, Part 1 | The EM & Acute Care Course

Serious Diseases: Outpatient Treatment, Part 1 by Rick Bukata, MD
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Key Points and Recommendations
1. Selected patients with low-risk PE and DVT can be safely managed as outpatients.
2. Use of the Pulmonary Embolism Severity Index (PESI) or its simplified version can aid in decision making concerning outpatient treatment.
3. Historically most patients in the studies on outpatient management of PE and DVT were treated with low- molecular-weight heparin until INR levels on warfarin were therapeutic, but there is emerging evidence for the use of NOACs.
4. Community acquired pneumonia (CAP) can be safely treated in an outpatient setting in selected low-risk patients.
5. The Pneumonia Severity Index (PSI) can be used to aid in decision making concerning outpatient treatment of CAP but should not be used as the sole criterion.
6. In systems that incorporate the PSI in decision making for CAP, more patients will be treated as outpatients.
7. Both the PESI and the PSI can be calculated using commercially available apps or online.
8. Selected patients with a spontaneous pneumothorax can be considered for outpatient treatment depending upon their response to initial treatment of the pneumothorax.
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[@ianlight2141]

Pulmonary Embolus with DOACS are PPI strong recommendation

[@ianlight2141]

Hospital in home by person or videoconference three times a day

[@ianlight2141]

Good to start getting levels of anti factor Ten and anti thrombin .
Levels available not being done