Pneumothorax | Pulmonary Embolism (case-based discussion, theory and quiz)

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NICE 2020 PE anticoagulation update: cks.nice.org.uk/pulmonary-embolism#!scenario:1. The most significant changes have been in the investigation unprovoked PEs, and the management of patients with cancer. - Unprovoked PE: all patients should be examined and have a full set of bloods Patients do NOT need further investigation unless they have signs or symptoms of cancer. This is in contrast to previous guidance which advised CT imaging in those above 40 years of age - Active cancer: consider a DOAC (e.g. rivaroxaban) (NOT LMWH). Offer anticoagulation for 3 to 6 months - No renal impairment: offer apixaban or rivaroxaban - Renal impairment: various options, such as LMWH or UFH - Provoked: consider stopping anticoagulation at 3 months - Unprovoked: consider continuing anticoagulation beyond 3 months. In clinical practice, this often translates to a total of 6 months anticoagulation