Monday, September 2, 2013

Pulmonary Embolus in Children: They Do Occur, But Who’s at Risk?

While pulmonary embolus (PE) sits prominently on the adult differential diagnosis of acute respiratory distress, we probably don’t think of it as often as we might in our younger patients. It is perhaps for that reason that Agha et al. (doi: 10.1542/peds.2013-0126) opted to review patients in their emergency department who were diagnosed with a pulmonary embolus from 2003 to 2011.  While only 105 PEs were identified from over one million patient visits, this is still a number we can learn from—and learn we do in this article in terms of demographic risk factors as well as whether these patients would have been identified using adult exclusionary criteria or missed in their diagnosis. The authors indicate that even children with PEs are not just little adults and instead require their own specific clinical decision rules if we are going to have a high pretest probability of diagnosing and not missing a pulmonary embolus in our pediatric patients. You’ll breathe easier if you read this study to learn more.