Madrid centre activates a protocol to improve pulmonary embolism care

Hospital Ramón y Cajal of Madrid is the first Spanish centre to activate the PE Code (pulmonary embolism), an action protocol for patients with pulmonary embolism that is already working in other European and American hospitals.

The PE Code consists of a group of specialists experienced with pulmonary embolism (PE) who agree on a treatment regimen in real time for the acute phase of the disease, explains David Jiménez, head of the hospital’s Pneumology Department.

These doctors make themselves available to their colleagues at no expense to receive calls at any moment and to propose the best procedure for patients telematically.

“The only objective of the PE Code is to improve the management of patients with PE,” says Dr Jiménez. Initially, it will not be used in all the hospital’s cases of pulmonary embolism, only in patients with more serious illness.

“It has many potential applications for the future, but we cannot expect every hospital to have its own PE Code,” he admits, although he also hopes that it becomes common practice, as in the case of the Stroke Code and Infarction Code.

PE, a disease with bright spots and shadows 

“We do not know if application of the PE Code will translate into an improvement for patients because there are no relevant clinical trials, but we believe that it could,” says the specialist.

“There are still many grey areas in PE management,” he acknowledges. “Clinical practice guidelines are wonderful because they help us to make some decisions about patients. However, they also have drawbacks because they do not deal with many cases that we see in daily practice.” Surely patients of this type are the ones who can benefit the most from the PE Code.

The RIETE Registry, which was originally developed to collect data in order to determine the best way to treat patients whose thrombosis and/or pulmonary embolism is not covered by the clinical practice guidelines, is also useful in these situations.

“Doctors have assimilated the information about RIETE and we automatically refer to it in cases that fall outside the guidelines,” Jiménez points out.

Hospital Ramón y Cajal launched the PE Code almost three months ago. This protocol was developed in Massachusetts General Hospital (USA) and has gradually spread throughout the United States and Europe, where there is already a consortium of centres applying it, the PERT Consortium.