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 #375: Retrograde Urethrogram

Podcast #375: Retrograde Urethrogram

Author: Jared Scott, MD Educational Pearls: Blood at urethral meatus in trauma can be a sign of bladder/urethral injury Blind placement of a Foley catheter can make an undiagnosed urethral injur...

6 Syys 20185min

Podcast #374:  Iliac Artery Endofibrosis

Podcast #374: Iliac Artery Endofibrosis

Author:  Sue Chilton, MD Educational Pearls:   An unusual cause of leg pain that can mimic sciatica/claudication Predominantly occurring in high endurance athletes, particularly cyclists and runner...

4 Syys 20183min

Podcast # 373: Legionnaires Disease

Podcast # 373: Legionnaires Disease

Author: Gretchen Hinson, MD Educational Pearls: Legionnaires disease refers to a severe pneumonia caused by Legionella pneumophilia and occurs typically at the extremes of age Associated gastroi...

1 Syys 20183min

Podcast # 372:  The Latest on Epinephrine in Cardiac Arrest

Podcast # 372: The Latest on Epinephrine in Cardiac Arrest

Author: Don Stader, MD Educational Pearls: 8014 patients with out-of-hospital cardiac arrest randomized to epinephrine vs placebo 30-day survival was not dramatically better between groups (3.2%...

30 Elo 20183min

Podcast # 371: EKG changes of Hyperkalemia

Podcast # 371: EKG changes of Hyperkalemia

Author: Jared Scott, MD Educational Pearls: EKG changes do not necessarily correlate to degree of hyperkalemia Traditional progression through peaked T-waves, flattened p-waves, QRS widening, an...

28 Elo 20183min

Podcast # 370:  Rapid Fire Neonatal Resuscitation

Podcast # 370: Rapid Fire Neonatal Resuscitation

Author:  Erik Verzemnieks, MD Educational Pearls:   In the panic of a precipitous ED delivery, remember: Warm. Dry. Stim.  It will solve most of your problems in most scenarios Start compressions i...

24 Elo 20181min

Podcast # 369:  Five powerful toxins - the definitive list?

Podcast # 369: Five powerful toxins - the definitive list?

Author: Michael Hunt, MD Educational Pearls: Here is a list of some very toxic natural substances:     #5: Tetrodotoxin: Found in pufferfish and other aquatic species #4: Ricin: made from castor beans...

22 Elo 20183min

Podcast # 368: Prehospital Plasma

Podcast # 368: Prehospital Plasma

Author: Aaron Lessen, MD Educational Pearls: Non-blinded randomized study assessing 30-day mortality benefit from plasma-first resuscitation in patients at risk hemorrhagic shock Study involved a...

20 Elo 20182min

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