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(1147)

Podcast # 498: Ortho Tips

Podcast # 498: Ortho Tips

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Podcast #497: Does my patient with CP have ACS?

Podcast #497: Does my patient with CP have ACS?

Author: Dylan Luyten, MD Educational Pearls: While certain aspects of the history, exam, and EKG may increase likelihood of ACS, there is no one element that performs well on its own Elements of the...

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Podcast # 496: Hallucinogens

Podcast # 496: Hallucinogens

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Podcast #494: A Standard Toxicology Approach

Podcast #494: A Standard Toxicology Approach

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Podcast # 493: One Pill for the Kill

Contributor: JP Brewer, MD Educational Pearls: Because of their smaller size, there are a variety of adult-dose pills that are potentially toxic to children. The most common categories of medication...

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Podcast # 492: Pain While on Buprenorphine

Podcast # 492: Pain While on Buprenorphine

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Podcast # 491: Buprenorphine for Withdrawal

Podcast # 491: Buprenorphine for Withdrawal

Educational Pearls: Buprenorphine is a semi-synthetic derivative of the opium poppy FDA approved for the treatment of opiate use disorder and chronic pain Benefit in emergency department use is the c...

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