Keywords:
Arteries / Aorta, Pulmonary vessels, Respiratory system, CT, CT-Angiography, Audit and standards, Screening, Acute, Embolism / Thrombosis
Authors:
K. P. Settipalli, B. Powell
DOI:
10.26044/ranzcr2023/C-301
Purpose
This audit aims to determine the appropriateness of Computed Tomography Pulmonary Angiogram (CTPA) requests at a single-site emergency department (ED) in a regional hospital, using the Queensland Health (QH) suspected Pulmonary Embolism (PE) diagnostic pathway as the standard of reference. We aim to demonstrate that use of D-dimer testing in accordance with this pathway could potentially reduce the rate of CTPA performance with a resultant reduction in ionising radiation exposure, potential contrast reactions, overdiagnosis of clinically inconsequential PEs1 and expense to the hospital, as well as improved patient flow.
Learning objectives:
- Determine the local positive CTPA rate for patients being investigated for PE
- Determine the proportion of CTPA studies that could have been avoided by the utilisation of D-dimer testing, and appropriate use of the ADJUST-PE or PEGeD criteria