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.

Episoder(1145)

Podcast 702: Paralytic Awareness

Podcast 702: Paralytic Awareness

Contributor: Aaron Lessen, MD Educational Pearls: Known risk factors for being awake and paralyzed in the OR include only receiving IV medications, long-acting paralytics, and no formal monitoring sy...

9 Aug 20212min

Podcast 701: Elevated Blood Pressure Readings

Podcast 701: Elevated Blood Pressure Readings

Contributor: Aaron Lessen, MD Educational Pearls: Recent retrospective cohort study looked at elevated BP readings in the ED and correlation to underlying hypertension Large cohort of over 30,000 pat...

3 Aug 20213min

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Contributor: Aaron Lessen, MD Educational Pearls: Recent RCT compared pain relief in patients receiving five medications for acute musculoskeletal pain Acetaminophen 1000mg/ibuprofen 400 mg Acetam...

2 Aug 20212min

Podcast 699: Pediatric Fingernail Avulsions

Podcast 699: Pediatric Fingernail Avulsions

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, fingernails were replaced after avulsion using sutures Sometimes artificial material was placed when the fingernail was not available ...

28 Jul 20213min

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Contributor: Aaron Lessen, MD Educational Pearls: Survey of EM physicians to self-report empathy and burnout levels and correlated with patient satisfaction scores Patient satisfaction was not affect...

27 Jul 20212min

Podcast 697: Kounis Syndrome

Podcast 697: Kounis Syndrome

Contributor: Aaron Lessen, MD Educational Pearls: Kounis syndrome is an allergic acute coronary syndrome Triggers include medications (antibiotics), insect bites, or other common allergens Believed t...

26 Jul 20213min

Podcast 696: ST Elevation and Differential Diagnoses

Podcast 696: ST Elevation and Differential Diagnoses

Contributor: Peter Bakes, MD Educational Pearls: ST elevation clinical guidelines for myocardial infarction include: 2.5 mm elevation for males 2 mm elevation in males >40 in V2 and V3 1.5 mm elev...

21 Jul 20214min

Podcast 695: Einstein and Cellophane

Podcast 695: Einstein and Cellophane

Educational Pearls: Albert Einstein had chronic abdominal pain as a middle-aged man Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found an ...

20 Jul 20213min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-nysgjerrige-norge
rss-rekommandert
sinnsyn
forskningno
rss-paradigmepodden
villmarksliv
vett-og-vitenskap-med-gaute-einevoll
fjellsportpodden
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
aldring-og-helse-podden
pod-britannia
tidlose-historier