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The Emergency Department for Your First PE/DVT: When to Go and What to Expect 

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Taking a trip to the emergency department is something that very few people enjoy doing. It can be very stressful, there’s a lot of waiting involved, and it can be costly. However, for many patients it can be a life-saving trip. For patients with deep vein thrombosis or pulmonary embolism, it is especially important that they receive the treatments they need in a timely manner.

If you believe you may have a blood clot, it is important for you to seek treatment.

When should you go to the Emergency Department?

It can be difficult to decide when you should go to the Emergency Department. By knowing the signs and symptoms of deep vein thrombosis and pulmonary embolism, you can empower yourself to make the best healthcare decisions for you.

Signs of deep vein thrombosis (DVT) include:

  • Swelling of the legs, ankles, or feet
  • Discomfort, heaviness, pain, aching, throbbing, itching, or warmth in the legs
  • Skin changes in the leg such as discoloration, thickening, or ulceration

Signs of pulmonary embolism include:

  • Sudden shortness of breath
  • Chest pain
  • Coughing up blood
  • Rapid or irregular heart rate

What can you expect if you believe you have a pulmonary embolism or deep vein thrombosis?

While every patient’s trip to the emergency department is different, there are a several things that you can expect when you visit. First, after waiting to be seen, a medical professional will take your medical history. In order to help your physician provide the best treatment for you, it’s important to know all of the medications you’re on. 

Once you’ve provided your medical history, you will then be examined and the physician will decide on what steps to take next. They will take into consideration your symptoms and your medical history.

Imaging is often the next step towards diagnosis. This can happen in several ways.

For DVT, an ultrasound is the most common diagnostic test. This form of imaging uses sound waves to create a picture of the arteries and veins in the leg. Doctors also can order a blood test known as the D-dimer test. 

In order to diagnose PE, doctors can use imaging tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI) scans. CT scans are the more popular diagnostic tool, but doctors will avoid using them if they’re unnecessary, as they expose patients to mild radiation.

Throughout your experience at the emergency department, it’s important to ask questions about anything you don’t understand. It’s normal for you to be seen by multiple different healthcare providers, including nurses and physician assistants. All of these medical professionals are there to be a resource for you.

“Don’t be afraid to ask questions. In the emergency room, it’s not uncommon to be seen by nurses and multiple providers,” said Dr. Jeremiah Schuur, Director of Quality, Patient Safety and Performance Improvement for the Department of Emergency Medicine of the Brigham and Women’s Hospital. “While they are all talking, it’s a good idea to ask questions to make sure you understand both what the physician is considering and what the plan is.”

Will you be admitted to the hospital or sent home? 

It’s hard to say if you will be admitted or sent home.

Patients diagnosed with DVT can be discharged and sent home with injectable or oral anticoagulation medicine. That said, every patient is different and patients can be admitted to the hospital if their physician believes it’s necessary.

Similarly, you might be surprised to find that certain patients with PE can also be discharged, according to Dr. Schuur. Studies have shown that it is safe for the right patient group, such as patients who have no other health risks and only have a small PE. This is a practice used in Europe and is less common in the United States. It is safest to assume you’ll be admitted to the hospital for treatment.

What do I do after discharge?

After your visit to the emergency department, it’s important to follow up with your primary care physician. They can help guide the next phase of your treatment. They may refer you to a doctor who specializes in cardiovascular disease.

DVT and PE symptoms should always be taken seriously. The emergency department is there to help you in times of need. It is always better to go in and be told you’re healthy, then to not go in and miss your opportunity to get vital treatment.

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