#Epi 36 - ICU Fellowship Snippet - Pulmonary Embolism: Risk Stratification & the New AHA/ACC Guidelines
Release Date: 08/12/2026
ICU Fellowship PrepCast
In this episode, Dr Swapnil Pawar and Dr Madhuri Anupindi work through a case-based viva on acute pulmonary embolism: a 40-year-old with a CTPA-proven saddle PE after a long-haul flight. We cover: – Risk stratification using the 2019 ESC guidelines: sPESI, haemodynamic criteria, and the imaging and biomarker evidence of RV strain – The brand-new 2026 AHA/ACC guidelines and their A–E classification, including respiratory modifiers and SCAI shock stages – Advantages and disadvantages of the new AHA/ACC framework versus the ESC approach — a likely compare-and-contrast question for the...
info_outlineICU Fellowship PrepCast
In this episode, we discuss the management of a 75-year-old patient who develops bloody diarrhoea on day two following endovascular aneurysm repair (EVAR) for a ruptured abdominal aortic aneurysm. We cover the differential diagnosis, the mechanisms of ischaemic colitis in this setting, the investigations used to evaluate it, and the principles of operative and non-operative management.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the management of a 72-year-old patient presenting with massive upper GI bleeding from an aortoenteric fistula following endovascular AAA repair. We cover the differential diagnosis, immediate resuscitation priorities, and the post-operative management of acute kidney injury, including the evidence base for early versus delayed renal replacement therapy.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the clinical presentation and management of various complications associated with subarachnoid haemorrhage.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the management of a post-splenectomy patient admitted to the intensive care unit.
info_outlineICU Fellowship PrepCast
In this epsiode, we discuss the clinical presentation and management of a patient with ascending cholangitis.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the multi-modal approach to neuroprognostication in out of hospital cardiac arrest patient.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the challenges and an approach for weaning long term mechanically ventilated patient in intensive care.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the clinical presentation and management of a patient presenting to regional ED with acute subdural haematoma.
info_outlineICU Fellowship PrepCast
In this episode, we discuss the challenges involved in the management of an obese patient admitted to intensive care after OHCA.
info_outlineIn this episode, Dr Swapnil Pawar and Dr Madhuri Anupindi work through a case-based viva on acute pulmonary embolism: a 40-year-old with a CTPA-proven saddle PE after a long-haul flight.
We cover:
– Risk stratification using the 2019 ESC guidelines: sPESI, haemodynamic criteria, and the imaging and biomarker evidence of RV strain
– The brand-new 2026 AHA/ACC guidelines and their A–E classification, including respiratory modifiers and SCAI shock stages
– Advantages and disadvantages of the new AHA/ACC framework versus the ESC approach — a likely compare-and-contrast question for the upcoming Fellowship exam
– Management of intermediate–high risk PE: anticoagulation (and why LMWH beats a heparin infusion), full-dose vs reduced-dose systemic thrombolysis (PEITHO, MOPETT), catheter-directed thrombolysis (HI-PEITHO), suction and surgical embolectomy, RV support strategies, and the role of the PERT team
Detailed tables comparing the ESC and AHA/ACC classifications, plus the sPESI criteria, are in the show notes at critcareedu.com.au.
Want to go deeper on the new guidelines? We break them down in full on the latest episode of the eCritCare Podcast.