Pulmonary Embolism

When to Transfer a Pulmonary Embolism Patient

Knowing when to transfer a pulmonary embolism (PE) patient is crucial for their well-being. Swift action can be life-saving and prevent complications. This guide explores the factors influencing the decision to transfer a pulmonary embolism patient and outlines essential considerations for a successful transfer.

Understanding Pulmonary Embolism

Pulmonary embolism occurs when a blood clot travels to the lungs, posing serious health risks. The two major issues patients may have include hemodynamic compromise and inability to oxygenate their blood. Quick diagnosis and treatment are essential to prevent further complications.

When to Transfer a Pulmonary Embolism Patient

There are no clear established guidelines that can help us make a sound decision. But there are a few factors we can consider:

  1. Severe Symptoms: If the patient shows severe symptoms like low blood pressure or shock, immediate transfer to a specialized facility is necessary. Note, that patients that decompensate will need stabilization before transfer.
  2. Need for Intensive Care: Patients requiring intensive care due to breathing difficulties or low oxygen levels or due to hemodynamic compromise, should be transferred to a hospital with advanced care units.
  3. Specialized Treatments: Patients needing specialized procedures like surgical embolectomy or catheter based thrombolytic therapy may warrant transfer to facilities equipped to perform these interventions safely.
  4. Diagnostic Complexity: Uncertain diagnoses or complications may require transfer to centers with specialized expertise and diagnostic tools. For instance, some centers will have a well developed PE response team.

There is one study that tried to offer objective criteria for patient transfer. In this single-center, retrospective, study, a regional PERT center received 532 requests for transfer. They observed that patients with a low Bova score never required advanced therapies, while patients with a higher score did.

How to Safely Transfer a Pulmonary Embolism Patient

Once you have decided to transfer a patient, you should strive to do so safely. Again, there are no specific guidelines for this, but there are a few factors to consider:

  1. Stabilize the Patient: Ensure the patient is stable before transfer by providing necessary medical interventions and support.
  2. Effective Communication: Maintain clear communication between referring and receiving facilities to provide comprehensive patient information.
  3. Transport Arrangements: Arrange appropriate transportation based on patient stability and distance to the receiving facility.
  4. Documentation: Document the transfer process thoroughly for legal and continuity of care purposes.

Considerations for Optimizing Patient Care

When transferring a patient, there are always a few factors to consider:

  1. Timeliness: Act swiftly to minimize delays in transfer and access specialized care promptly.
  2. Risk Assessment: Evaluate the benefits and risks of transfer for each patient, considering factors like PE severity and comorbidities.
  3. Collaborative Approach: Work with a multidisciplinary team to optimize patient management and decision-making.
  4. Post-Transfer Care: Ensure seamless continuity of care by providing comprehensive discharge summaries and follow-up instructions.


Understanding when to transfer a PE patient is crucial for their well-being. By following established guidelines and considering individual patient factors, healthcare providers can ensure timely access to specialized care, ultimately improving patient outcomes.

Dr. Ido Weinberg

Dr. Ido Weinberg is a Vascular Medicine specialist at Massachusetts General Hospital. He is President-Elect of the Society for Vascular Medicine. Dr. Weinberg treats hundreds of patients with blood clots every year. He publishes extensively on blood clots and he speaks frequently about blood clots in international conferences.

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