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

Episoder(1146)

Podcast #303: Lazarus Effect

Podcast #303: Lazarus Effect

Author: Dylan Luyten, M.D. Educational Pearls The Lazarus phenomenon is the delayed return of spontaneous circulation after cessation of CPR. A prospective study in Finland found 5 out of 840 patient...

9 Mar 20183min

Podcast #302: Flu

Podcast #302: Flu

Author: Jared Scott, M.D. Educational Pearls Flu is widespread throughout the US (through Jan 20th 2018). All age groups have seen surge in hospitalizations, but 65 + age group has seen the largest s...

7 Mar 20183min

Podcast #301: Biliary Pathology

Podcast #301: Biliary Pathology

Author: Don Stader, M.D. Educational Pearls Common pathologies include cholecystitis, choledocholithiasis, and in concerningly ascending cholangitis. Cholecystitis is obstruction at the cystic duct l...

5 Mar 20183min

Opioid Safety Summit: Admiral Winnefeld's Strategy to Wage War on the Opioid Epidemic

Opioid Safety Summit: Admiral Winnefeld's Strategy to Wage War on the Opioid Epidemic

Since the tragic overdose of his son, Admiral Winnefeld has developed an intriguing strategy on how to combat the Opioid Epidemic.

27 Feb 20180s

Dreamland in Denver Part VI: "Dreamland"

Dreamland in Denver Part VI: "Dreamland"

Sam Quinones, American journalist and author of the critically acclaimed book, Dreamland: The True Tale of America's Opiate Epidemic, shares the story of how he discovered the truth about the Opiate E...

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Dreamland in Denver Part V: "Tales from a Harm Reductionist"

Dreamland in Denver Part V: "Tales from a Harm Reductionist"

Lisa Raville, executive director of The Harm Reduction Action Center in Denver, shares tales from her perspective as a Harm Reductionist.

16 Feb 201810min

Dreamland in Denver Part IV: "Doing Harm: Medicine's Role in Creating the Opioid Crisis."

Dreamland in Denver Part IV: "Doing Harm: Medicine's Role in Creating the Opioid Crisis."

Emergency Medical Minute's very own Donald Stader, MD explains Medicine's contribution to the catastrophe that is the Opioid Epidemic.

16 Feb 201819min

Dreamland in Denver Part III:  "Opioid Mythbusters: 10 Fallacies that Fueled the Opiate Crisis"

Dreamland in Denver Part III: "Opioid Mythbusters: 10 Fallacies that Fueled the Opiate Crisis"

Dr. Robert Valuck, director of the Colorado Consortium, presents 10 fallacies that have fueled the Opioid Epidemic.

16 Feb 201819min

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