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 # 335: Blunt Head Trauma

Podcast # 335: Blunt Head Trauma

Author: Peter Bakes, M.D. Educational Pearls: Epidural hematomas have a characteristic convex appearance on CT while a subdural hematoma will have a concave appearance. Indications for operative ...

29 Touko 20188min

Podcast #334 - Resuscitative Thoracotomy

Podcast #334 - Resuscitative Thoracotomy

Author: Dylan Luyten, MD Educational Pearls: Resuscitative thoracotomies are most commonly used for treatment of cardiac tamponade and to selectively perfuse the brain and heart in setting of hemor...

25 Touko 20187min

Podcast #333 - TBI Prognosticators

Podcast #333 - TBI Prognosticators

Author: Michael Hunt, MD Educational Pearls: Studies have shown that patients with decreasing GCS scores have worse outcomes, however GCS of 4 has worse outcome than GCS 3. Alternative scoring sy...

23 Touko 20183min

Podcast #332 - Door To Furosemide Time

Podcast #332 - Door To Furosemide Time

Author: Nick Hatch, MD Educational Pearls: Recent study argues that CHF patients receiving furosemide within 60 minutes of arrival had a lower in-hospital mortality than those receiving it after (2...

21 Touko 20182min

Podcast # 331:  Oral Rehydration Therapy (ORT)

Podcast # 331: Oral Rehydration Therapy (ORT)

Author: Nick Hatch, MD Educational Pearls: The sodium-glucose cotransporter in the gut is essential for rehydration. Oral rehydration therapies require an equimolar concentration of glucose and s...

19 Touko 20184min

Podcast # 330:  Behcet Disease

Podcast # 330: Behcet Disease

Author: Nick Hatch, MD Educational Pearls: Behcet Disease is an autoimmune disease that can affect any organ system. Typical symptoms include recurrent oral and genital ulcers, but more concernin...

17 Touko 20184min

Podcast # 329:  Hypokalemic Periodic Paralysis

Podcast # 329: Hypokalemic Periodic Paralysis

Author: Dylan Luyten , MD Educational Pearls: Rare autosomal dominant condition that is often misdiagnosed as a psychiatric illness. Presents as profound muscle weakness with frank paralysis that...

15 Touko 20183min

Podcast # 328:  Sleep Deprivation

Podcast # 328: Sleep Deprivation

Author: Sam Killian, MD Educational Pearls: Insufficient sleep and disrupted circadian rhythms are a major health problem today Millions of dollars, thousands of deaths, and millions of injuri...

11 Touko 20185min

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