“… 15 , 16 , 17 , 18 , 19 , 20 However, patients with severe acute VTE may benefit from the addition of invasive “reperfusion strategies.” Although current literature suggests that clinical equipoise and considerable controversy exists over this decision, if reperfusion strategies are likely to help, experts believe they should be initiated within a few hours of diagnosis. 21 , 22 , 23 , 24 The diagnosis of VTE and its treatment thus represent a model system of an emergent condition that requires immediate decision making under conditions of uncertainty regarding optimal treatment choice and where both the failure to treat and the complications from treatment can be life threatening. Furthermore, most of these patients will present to the emergency department (ED), where a patient–health care provider relationship has not been developed or maintained.…”