Initiation of a Multidisciplinary, Rapid Response Team to Massive and Submassive Pulmonary Embolism
Section snippets
Methods
MASCOT was formed at Beth Israel Deaconess Medical Center (BIDMC) to include experts in thrombosis, critical care, cardiogenic shock, and catheter-based interventions employed in acute massive and submassive PE. The team comprised subspecialists from cardiology, pulmonology, hematology, interventional radiology, and cardiac surgery. A virtual pager was created that can be accessed through the paging directory throughout the BIDMC and affiliated hospital network and is integrated into the BIDMC
Results
MASCOT was formed in August 2015 and formally evaluated 72 patients through September 2016. Virtual consultation occurred in 2 patients who were at an outside facility and were successfully managed at the referring institution by mutual agreement. Of the remaining 70 patients whom we evaluated at our institution, 37 (53%) had been transferred from an outside facility with a known or presumed diagnosis of PE. Consult requests originated from the ED in 49%, with the remainder from inpatient
Discussion
We describe logistics and initial experience of a multidisciplinary, rapid response PE team focused on high-risk PE. We demonstrate steady utilization over the first 14-month study period. We also describe the clinical characteristics of the high-risk PE population evaluated by the team, along with treatment strategies and in-hospital outcomes.
After its formation, MASCOT quickly became a well-recognized and employed consultative resource throughout the hospital, particularly by the ED. The
Acknowledgment
The authors thank Larry Nathanson, MD, for accumulating ED consult request data, and Stephanie Li for assistance in collection of ICD data.
Disclosures
Dr. Bauer reports consulting for Boehringer Ingelheim and Janssen. All remaining authors report no pertinent disclosures.
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