HCA HealthONE Swedish launches Pulmonary Embolism Response Team

In an acute care hospital like HCA HealthONE Swedish, the rapid identification and treatment of serious conditions can significantly improve patient outcomes. To better serve patients in the Denver metro experiencing pulmonary embolism, the hospital launched a Pulmonary Embolism Response Team (PERT), a multidisciplinary team of experts focused on rapidly diagnosing and applying the proper treatment for pulmonary embolism – a life-threatening blockage in one of the pulmonary arteries in the lungs that affects up to 900,000 people in the U.S. each year.

Dr. Akshay Vijayaraman, one of the doctors who led the push to bring PERT to HCA HealthONE Swedish, a Level 1 Trauma, Comprehensive Stroke and ABA-verified Burn and Reconstructive Center, says the strength of the program lies in its collaborative nature. “Diagnosis of a pulmonary embolism can be challenging... a lot of different diseases present with the same symptoms: chest pain and shortness of breath. To make sure, we order a CT scan to get a good look at the pulmonary arteries. Once a positive diagnosis is made, we call a PERT activation, which brings together doctors representing four specialties: the Intensive Care Unit (ICU), pulmonary care, cardiovascular and interventional radiology,” Dr. Vijayaraman said. Each PERT response is custom-tailored to the severity of the individual patient’s embolism. Sometimes a patient can receive medication and not even be admitted to the hospital, but the multidisciplinary team is also ready to respond to life-threatening emergencies, like it did on Thanksgiving Day 2024.

A patient felt sick and drove himself to the Emergency Department, where he went into cardiac arrest right after arriving. Emergency staff restarted his heart, administered anticoagulant medication and rushed him to a CT scan. Moments after imaging, he went into cardiac arrest again. While Emergency Department colleagues restarted the patient’s heart for a second time, doctors agreed the CT conclusively showed a pulmonary embolism, and they activated PERT. Within a few minutes, the multidisciplinary team decided a percutaneous suction thrombectomy was the best action to remove the patient’s clot. “Because we had the systems to rapidly diagnose his embolism and rely on each area of clinical expertise on this team, this patient’s outcome was significantly improved. I was one of the physicians attending to him, and after the procedure, he was stable and didn’t require any life support type medications,” Dr. Vijayaraman said.

The patient was discharged in a matter of days. He and other patients who have been treated for pulmonary embolism at HCA HealthONE Swedish have access to a dedicated follow-up clinic, something Dr. Vijayaraman said is crucial for managing post-treatment symptoms, “Most people have symptoms up to three months, and there are some people who have symptoms even up to 12 months after their pulmonary embolism. We want to ensure we're screening and, if necessary, treating those patients to provide the most complete recovery.”

Using a PERT is a relatively new concept, the first was established in 2012 at Massachusetts General Hospital, according to the National Institutes of Health. By embracing this emerging care model, providers at HCA HealthONE Swedish are helping to advance the field. “Because the disease and treatment options are so varied, there's still a need for more research in terms of best practice,” Dr. Vijayaraman said. “The more we can take care of these patients with pulmonary embolism, the more we can learn about optimal care.”

With its commitment to providing the highest level and quality of care to patients across the Rocky Mountain Region, providers at HCA HealthONE Swedish are working toward being recognized as a Pulmonary Embolism Center of Excellence by the PERT Consortium.

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