Timeframe: from diagnosis of thromboembolic venous disease until establishment of effective treatment

Setting: outpatient setting, inpatient setting, and emergency department

Including:

assessing a patient with superficial and deep vein thrombosis

implementing medical therapy

referring for interventional or surgical treatment

implementing secondary prevention

Excluding: Performing interventional or surgical treatment

• Medical epert

• Collaborator

• Professional

• Describe the epidemiology of deep vein thrombosis

• Recall the major risk factors for deep vein thrombosis

• Describe the pathophysiology of pulmonary embolism

• Describe the clinical presentation of superficial and deep vein thrombosis

• Describe the clinical presentation of pulmonary embolism

• Explain the diagnosis of deep vein thrombosis by duplex examination of leg and pelvic veins

• Discuss the value and limitations of investigations for the diagnosis of pulmonary embolism

• Describe the treatment of acute pulmonary embolism by:

  •   – Anticoagulant therapy

  •   – Thrombolytic therapy

  •   – Embolectomy

• Describe the management of chronic thromboembolic pulmonary hypertension, including thrombo endarterectomy

• Recall preventive measures for deep venous thrombosis /pulmonary embolism

• Take a relevant history and perform an appropriate clinical examination

• Perform and interpret the following diagnostic modalities:

  •   – ECG

  •   – Transthoracic echocardiography

  •   – Trans-oesophageal echocardiography

• Interpret the following diagnostic modalities:

  •   – Chest X-ray

  •   – Blood tests including the use of D-dimer and troponins

  •   – Pulmonary angiography

  •   – CT angiography

  •   – MR angiography

  •   – Ventilation-perfusion-scanning

• Implement appropriate therapy for acute pulmonary embolism and chronic thromboembolic pulmonary hypertension

• Diagnose and manage acute and chronic deep vein thrombosis

• Determine the duration of anticoagulant therapy for a patient with thromboembolic venous disease

• Appreciate of the difficulties in diagnosing pulmonary embolism on the basis of symptoms and signs

• Collaborate with other imaging experts including radiologists and nuclear imaging specialists

• Ensure patient understanding of the disease and the importance of compliance with, and the precautions required during long-term anticoagulant therapy

• Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

• CbD (case-based discussion)/EbD (entrustment-based discussion)

• 4. Distant supervision