Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D.

Educational Pearls

  • In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification. The goal of the study was to show that CT scan usage could safely reduced using this screening method.
  • The Wells Criteria measures they used to stratify risk were: PE mostly likely dx, hemoptysis, and evidence of DVT. If the d-dimer was 1, but the patient had none of the Wells criteria, the patient did not get a CT. If the patient had any of the criteria, but the d-dimer was only 0.5, the patient did not get a CT scan.
  • The investigators reduced CT usage by 14% using the new criteria, with no significant increase in morbidity and mortality.

References: van der Hulle et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. The Lancet. 2017

Jaksot(1146)

Podcast #243: Sphenopalatine Nerve Block

Podcast #243: Sphenopalatine Nerve Block

Author: Don Stader, M.D. Educational Pearls Cluster headaches are usually intense, unilateral, and involve the periorbital area. CN V (Trigeminal) provides sensory and autonomic innervation the face...

25 Elo 20174min

Podcast #242: Pott's Puffy Tumor

Podcast #242: Pott's Puffy Tumor

Author: Suzanne Chilton, M.D. Educational Pearls Pott's puffy tumor is a subperiosteal abscess of the frontal bone that arises from hematologic spread or direct infection via the frontal sinuses. The...

23 Elo 20173min

Podcast #241: GERD vs. MI

Podcast #241: GERD vs. MI

Author: Dave Rosenberg, M.D. Educational Pearls MI and GERD can present similarly. For example, 47% with angina report increased belching with an anginal attack, and 20% of people with an MI describe...

21 Elo 20173min

Podcast #240: Honey and Burns

Podcast #240: Honey and Burns

Podcast #240: Honey and Burns Author: Nick Hatch, M.D. Educational Pearls Honey can be used to treat burns because it has antibacterial properties. In one study, honey outperformed silver sulfadiazin...

19 Elo 20172min

Podcast #239: Tetanus in the ED

Podcast #239: Tetanus in the ED

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist - Emergency Medicine Educational Pearls Tetanus Ig is indicated in those who have no or unknown tetanus vaccination history who present with...

17 Elo 20173min

Podcast #238: Ultrasound in Cardiac Arrest

Podcast #238: Ultrasound in Cardiac Arrest

Author: Aaron Lessen M.D. Educational Pearls Ultrasound is helpful in the setting of cardiac arrest for finding a cause like cardiac tamponade or PE, but also for predicting outcomes for non-shockab...

15 Elo 20171min

Deep Dive #5: The Evolution of Sepsis Treatment

Deep Dive #5: The Evolution of Sepsis Treatment

Author: Susan Brion, M.D. Dr. Brion enlightens us on the ever-evolving standard of sepsis management.

11 Elo 201722min

Podcast #237: Phimosis vs. Paraphimosis

Podcast #237: Phimosis vs. Paraphimosis

Author: Sam Killian, M.D. Educational Pearls Phimosis refers to the inability to retract the distal foreskin over the glans penis in uncircumcised males. Paraphimosis is the entrapment of the foreski...

9 Elo 20174min

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