[pert] Updates

[Debanik Chaudhuri]

This is exactly the point I made before in the PERT. I am surprised this issue is still going on. This is wrong language and will not be part of the form. We would need only the following and no more:


  1.  RV: LV ratio as a number. Helpful only as a measure of RV strain. Positive troponin and proBNP serve the same role biochemically.
  2.  There is no need for mentioning clot burden as massive or sub-massive. It will only create misunderstanding.  It is a clinical/hemodynamic diagnosis, not a radiological one. Dr. Ramakrishnan’s suggestion regarding location of thrombus is an appropriate one.



From: pert <pert-bounces at lists.upstate.edu> On Behalf Of Kartik Ramakrishna
Sent: Monday, May 3, 2021 10:53 AM
To: Harvir Singh Gambhir <GambhirH at upstate.edu>
Cc: pert at lists.upstate.edu; Sherri A. Adamo-Turner <AdamoTuS at upstate.edu>
Subject: Re: [pert] Updates

Hi,

I’m confused by the points in the image you sent.
1. Location: left ventricle, right ventricle…

Are we asking if the PE is in the left or right ventricle???

2. Clot burden: massive, submissive…

I object to this language…. Massive and submissive are specific clinical definitions used to stratify severity of a PE. Using this language for radiographic descriptions is going to lead to confusion.

To comment on LV/RV ratio and mean PA diameter for review purposes later is reasonable.

Regarding clot burden, my suggestion would be to have options such as subsegmental, segmental, lobar, saddle, number of segments involved. Or we should check with radiology to see if they have a more standardized way of quantifying clot burden.

Regards,

Kartik


On May 3, 2021, at 10:22 AM, Harvir Singh Gambhir <GambhirH at upstate.edu<mailto:GambhirH at upstate.edu>> wrote:

Good Morning All,

Epic Team is looking feedback from all and complete this.

EPIC team:-“We just need to know what the group thinks is best.  The three fields in question are at the top of the PERT form”

<image001.jpg>

Would we like to remove one or all of these questions, or keep them and change the verbiage?  Once this is confirmed, we should be able to move forward.

This was discussed in one of the meetings:

CTA thorax based:-
LV/RV Ratio =
Clot Burden =

Thank you for time and attention.




HSG
Regards,
Harvir Singh Gambhir MD, FACP, CPL, CPHQ
Associate Program Director, Internal Medicine Residency Program,
Associate Vice Chair for Quality Improvement & Patient Safety, Department of Medicine,
Quality Officer, Division of Hospital Medicine,
Assistant Professor & Hospitalist,
SUNY Upstate Medical University,
750 E Adams Street,
Syracuse, NY 13210.


From: pert <pert-bounces at lists.upstate.edu<mailto:pert-bounces at lists.upstate.edu>> on behalf of Christopher T. Tanski <TanskiC at upstate.edu<mailto:TanskiC at upstate.edu>>
Date: Monday, April 26, 2021 at 3:03 PM
To: pert at lists.upstate.edu<mailto:pert at lists.upstate.edu> <pert at lists.upstate.edu<mailto:pert at lists.upstate.edu>>
Subject: [pert] Updates
Hi-

The PERT committee met last week and approved finalized versions of the policy and procedure, which I have attached. These have now been submitted to the following groups/councils/committees for approval: medicine shared governance, surgery shared governance, procedural shared governance, ICU governance, critical care shared governance, resuscitation and legal.

In addition, our membership in the PERT Consortium is proceeding. I will need to submit a project request to our IRB for approval to send anonymous data to the registry. They may or may not require some sort of consent document.

Lastly, the hospital is moving toward high sensitivity (fifth generation) troponin T as opposed to "conventional" troponin. We will need to see how/if that makes a difference in how we use troponin in the assessment of PE burden.

Thanks.

Chris

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