Massive pulmonary embolism treated with low-dose thrombolysis on the geriatric ward during the COVID-19 pandemic.
BMJ Case Rep
; 15(4)2022 Apr 06.
Article
in English
| MEDLINE | ID: covidwho-1779332
ABSTRACT
A man in his 70s was admitted to hospital due to a fall, urinary tract infection and delirium. The patient had a 'do not attempt cardiopulmonary resuscitation' order in place and a ward-based ceiling of care was agreed. He tested positive for COVID-19 while on a geriatric ward and subsequently developed bilateral pulmonary emboli with haemodynamic instability. The patient had a significant bleeding risk; however, the expected morbidity and mortality risk from the pulmonary emboli was high. A decision was made to give the patient low-dose thrombolysis on the geriatric ward, following which he made a full recovery. Acute thrombolysis is normally performed in emergency department, high dependency unit (HDU) or intensive care unit (ICU) settings; however, this was not possible in this case due to the burden the COVID-19 pandemic had placed on HDU/ICU services and bed capacity. Adaptation of treatment guidelines allowed for emergency life-saving treatment to be delivered to this patient.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pulmonary Embolism
/
COVID-19
Type of study:
Case report
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Bcr-2021-248125
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