Soru

A 48-year-old man is evaluated in the emergency department for sudden-onset right-sided chest pain and mild shortness of breath that began earlier this morning. His medical history is significant for hypertension and severe alcohol use disorder. He is currently unhoused and sleeps at a local congregate shelter. Vital signs are temperature $37.2^\circ\text{C}$ ($99.0^\circ\text{F}$), blood pressure $135/85\text{ mmHg}$, pulse $92\text{/min}$, and respiratory rate $18\text{/min}$. Oxygen saturation is $96\%$ on room air. On physical examination, he is alert and oriented but appears mildly disheveled. The lungs are clear to auscultation bilaterally, and there is no right ventricular heave.

Computed tomography pulmonary angiography demonstrates a segmental pulmonary embolism in the right lower lobe. Laboratory studies show a serum troponin I level of $< 0.01\text{ ng/mL}$ (normal $< 0.04\text{ ng/mL}$), an NT-proBNP level of $80\text{ pg/mL}$ (normal $< 125\text{ pg/mL}$), and a serum creatinine of $0.9\text{ mg/dL}$. His Pulmonary Embolism Severity Index (PESI) score is calculated to be $58$ (Class I, very low risk).

During the evaluation, the patient admits to drinking approximately one pint of vodka daily. He also mentions that his backpack, which contained his hypertension medications, was stolen at the shelter two days ago. He states that he feels much better after receiving a dose of intravenous acetaminophen and expresses a strong desire to leave the emergency department immediately to secure a bed at the shelter for the night.

Which of the following is the most appropriate next step in the disposition of this patient?