Podcast #320: PE in Pregnancy

Podcast #320: PE in Pregnancy

Author: Don Stader, M.D.

Educational Pearls:

  • Pulmonary embolism is one of the leading causes of maternal mortality.
  • There is disagreement among different medical societies about the value of D-dimer as a screening modality. If you use it, consider the rational D-dimer approach whereby you add 250 to your cut-off for every trimester.
  • A useful screening modality is an ultrasound of bilateral lower extremities looking for DVT.
  • Keep in mind, both a V/Q scan and CT scan have a significant amount of radiation. CTA is probably the right diagnostic test (less radiation than CT w&w/o).
  • Always use the shared decision-making model and clinical acumen to choose your tests.

References:

Leung AN, et. al. (2011). An official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline: evaluation of suspected pulmonary embolism in pregnancy. American Journal of Respiratory and Critical Care Medicine. 184(10):1200-8

Polak JF, Wilkinson DL. (1991). Ultrasonographic diagnosis of symptomatic deep venous thrombosis in pregnancy. American Journal of Obstetrics and Gynecology. 165(3):625-9.

Sachs BP, et. al. (1987). Maternal mortality in Massachusetts. Trends and prevention. New England Journal of Medicine. 316(11):667-72.

Jaksot(1145)

Podcast 774: Maggots

Podcast 774: Maggots

Contributor: Chris Holmes, MD Educational Pearls: Maggots were discovered as a therapy to help wound healing in WWI, but this fell out of favor after the discovery of penicillin One study from Israel...

19 Huhti 20225min

Podcast 773: Atrial Fibrillation Medications

Podcast 773: Atrial Fibrillation Medications

Contributor: Aaron Lessen, MD Educational Pearls: Atrial fibrillation is an irregular heart rhythm that sometimes requires rate control in setting of rapid ventricular response (RVR) Calcium channel ...

18 Huhti 20223min

Podcast 772: Firearms in Suicidal Ideation

Podcast 772: Firearms in Suicidal Ideation

Contributor: Aaron Lessen, MD Educational Pearls: Firearms are a dangerous potential method of committing suicide Death occurs in about 5-15% of suicide attempts overall, but death in suicide attempt...

12 Huhti 20224min

Podcast 771: Intubation in Cardiac Arrest

Podcast 771: Intubation in Cardiac Arrest

Contributor: Don Stader, MD Educational Pearls: In a secondary analysis of the PART trial, the mortality effect of timing of airway management for patients in cardiac arrest was examined Study looked...

11 Huhti 20223min

Podcast 770: Xylazine

Podcast 770: Xylazine

Contributor: Don Stader, MD Educational Pearls: Xylazine, referred to as tranq dope colloquially, is an FDA approved animal tranquilizer that is circulating in the illicit drug markets of the northea...

5 Huhti 20223min

Podcast 769: Pressors After Cardiac Arrest

Podcast 769: Pressors After Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hypotension after cardiac arrest often requires a vasopressor to improve blood pressure Recent observational study from France examined outcomes of p...

4 Huhti 20223min

Mental Health Monthly #11: De-escalation: Changing Confrontation to Collaboration

Mental Health Monthly #11: De-escalation: Changing Confrontation to Collaboration

Contributor: Dr. Kimberly Nordstrom De-escalation usually takes less time than physical and chemical restraints, which leads to decreased injury to staff members, better patient trust and increased p...

30 Maalis 202216min

Podcast 768: Takotsubo Cardiomyopathy

Podcast 768: Takotsubo Cardiomyopathy

Contributor: Peter Bakes, MD Educational Pearls: 3% of cases of acute coronary syndrome are due to Takotsubo Takotsubo cardiomyopathy or "broken heart syndrome" can occur with severe physiologic or ...

29 Maalis 20224min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa