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ObjectiveTo explore Young Persons (YP) and healthcare professionals (HCP) experiences of virtual consultations (VC) and establish whether developmentally appropriate healthcare can be delivered virtually.MethodYP and HCP questionnaire surveys were designed and piloted. Electronic questionnaire links were sent by post, email or text message January–April 2021 to YP aged 13–25 years old, with predefined chronic gastrointestinal conditions, attending a gastroenterology/hepatology VC. HCP undertaking VC were invited to complete staff questionnaire. Results were anonymous and collated using Excel version 2302.ResultsFive UK hospital trusts participated, with 35 HCP responses. Of the 100 YP completing the survey 66% were female and 34% male aged between 13 years and 25 years (median: 18 years). 13% were new appointments and 87% follow ups, 29% were by video, 69% by phone and 2% gave no response. 80% of HCP spoke to YP directly but not privately (69%). 87% of YP and 88% HCP found VC useful. 83% of YP want VC again, although 20% preferred face to face. 43% of HCP required improved phone/internet connection. 77% of YP required hospital appointments for tests following VC.ConclusionsOverall respondents were satisfied with VC, finding them useful, convenient and time saving. Successful VC rely on appropriate patient selection and availability of reliable technology. Patient preference is key which may alter with time.
ABSTRACT
INTRODUCTION: There is recent evidence that coronavirus disease 2019 (COVID-19) infection results in a prothrombotic state that may increase the risk of venous thromboembolism. Both COVID-19 infection and pulmonary emboli can present with dyspnoea, tachypnoea, hypoxaemia and an elevated D-dimer. Identifying a pulmonary embolus in a patient with COVID-19 and differentiating it from the typical clinical and biochemical features of COVID-19 is challenging. CASE REPORTS: We report four cases, and reviewed two further cases in the literature, of a pulmonary embolus in patients who presented to the emergency department with COVID-19 and no other risk factor for a pulmonary embolus. CONCLUSION: We identified a series of atypical features that should raise suspicion for a pulmonary embolus: pleuritic chest pain; haemoptysis; atrial fibrillation; tachycardia; hypotension; late onset deterioration; evidence of right heart strain; or a disproportionally elevated D-dimer in comparison to ferritin.