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PERT is an interdisciplinary effort to provide rapid assessment and treatment based upon the patient’s condition and best practice guidelines. Research has shown that a systematic approach to treating pulmonary embolism (PE) patients will increase time to treatment and decrease adverse events including mortality and long term heart failure.
A PERT ALERT is initiated on all patients diagnosed with a Sub-Massive or Massive PE to establish a mechanism for key personnel to rapidly evaluate and accurately risk stratify to provide evidence-based care and treatment. Patients are risk stratified in to 3 categories: Low Risk, Sub-Massive, or Massive. Potential patients appropriate for Catheter Based Treatment (CBT) are those stratified as Sub-Massive and Massive. Most patients qualify for Catheter Based Treatment. The goal of CBT is the removal of the obstructing thrombi from the pulmonary arteries to facilitate right ventricular recovery, and to improve symptoms and survival. This includes reduction of long term heart failure. CBT uses significantly less tPA than medical treatment (or systemic treatment), thus reducing bleeding complications. Few patients receive Surgical Pulmonary Embolectomy. By providing a systematic evidence based approach, we may be able to get patients to surgery before they decompensate to a point of no return.
The initial key person to contact is the Interventional Cardiologist on call for PERT ALERT. Additional persons can include pulmonologist, surgeon, hospitalist, hematologists and pharmacist. Nursing provides support by closely monitoring the patient’s condition for deterioration, ensuring rapid completion of tests such as Stat CT Scan, Stat Echo, EKG and lab work, and administering medications.
PERT Alerts should be called by the physician receiving the report of a confirmed PE. Once a PERT Alert has been activated a PERT Alert Algorithm will be followed as indicated in the PERT Alert Policy, #9856-261. The PERT Alert Policy went into effect system wide effective May 1st, 2018. The interventional cardiologist on call for PERT Alert can be found via the ED Call schedules.
The IT Team announced an upgrade to the Citrix Receiver 4.9 for all hospital service areas. The new Citrix Receiver is designed to eliminate desktop clutter and allow end users to manage their Citrix icons in a convenient “storefront.” The rollout will take place June 18th through June 22nd. The Help Desk will staff additional agents during the rollout and the Desktop Team will round on units to provide Support. The rollout schedule is as follows:
- Monday, June 18th Pharmacy & Lab
- Tuesday, Junet 19th Inpatient Nursing Units, Physician devices, Registration
- Wednesday, June 20th Surgical Services
- Thursday, June 21st Medical Imaging
- Friday, June 22nd Care Coordination
Potassium Chloride Injection Shortage – although product is still in short supply, Centegra pharmacies have been successful in obtaining supply. The manufacturer expects release on 8/23/18. At this time, we estimate we have at least a 4-week supply and can now begin using without restriction.