Podcast 647: INR and Liver Failure

Podcast 647: INR and Liver Failure

Contributor: Erik Verzemnieks, MD

Educational Pearls:

  • INR measures the clotting cascade including factors II, VII, IX, and X
  • Coumadin most commonly elevates the INR, and it is used to monitor the anticoagulant's effectiveness
  • Liver failure can cause a similar elevation in the INR due to lack of synthesis of factors II, VII, IX, X
  • An elevated INR in liver failure does not mean that the patient is anticoagulated, at increased risk for bleeding, or is at less risk of forming a clot
  • There is more commonly an increased risk of clot formation due to lack of production of protein C and S, which are natural anticoagulants
  • Lack of production of proteins C and S have a larger effect and lead to typically a net clotting risk
  • Levels of these can be indirectly measured through albumin
  • Portal venous thrombosis is one of the most common examples of this phenomenon

References

Harrison MF. The Misunderstood Coagulopathy of Liver Disease: A Review for the Acute Setting. West J Emerg Med. 2018;19(5):863-871. doi:10.5811/westjem.2018.7.37893

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Donate to EMM today!

Episoder(1146)

Podcast 604: Baclofen Withdrawal

Podcast 604: Baclofen Withdrawal

Contributor: Erik Verzemnieks, MD Educational Pearls: Baclofen is used to treat muscle spasms or spasticity. Baclofen comes in two forms: oral and intrathecal Withdrawal is much more common with thos...

13 Okt 20202min

Podcast 603: Don't Sedate. Block.

Podcast 603: Don't Sedate. Block.

Contributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation Nerve blocks are an effective alternative that can provide analg...

12 Okt 20203min

Podcast 602: Post-Narcan Observation

Podcast 602: Post-Narcan Observation

Contributor: Donald Stader, MD Educational Pearls: Not uncommon for patients presenting after opiate overdose and narcan administration to be observed for 4-6 hours This has been based more on tradit...

6 Okt 20204min

Podcast 601: Droperidol

Podcast 601: Droperidol

Contributor: Sam Killian, MD Educational Pearls: Droperidol (Inapsine) is an antipsychotic drug with efficacy for nausea, vomiting, headaches, and treating agitation In the early 2000's, Droperidol ...

5 Okt 20204min

Pediatric Emergencies Brewcast: Pediatric Fever

Pediatric Emergencies Brewcast: Pediatric Fever

Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies geared towards mid-level providers at a local Denver brewery for our latest...

30 Sep 202013min

Podcast 600: Penicillin Allergy?

Podcast 600: Penicillin Allergy?

Contributor: Aaron Lessen, MD Educational Pearls: True allergies to penicillin compared to reported allergies from patients ranges around 10% Recent study took patients undergoing sensitivity tests a...

29 Sep 20202min

Podcast 599: Facial Blocks for the Win

Podcast 599: Facial Blocks for the Win

Contributor: Don Stader, MD Educational Pearls: Local anesthetics injected directly into wounds can cause distortion - especially important in facial lacerations Several blocks can be helpful to help...

28 Sep 20205min

UnfilterED #10: Debi Smith

UnfilterED #10: Debi Smith

General Counsel attorney, Debi Smith, joins Dr. Nick Tsipis to discuss the ins and outs of healthcare law. Many people forget that a subpoena only compels attendance to a court date, it does not compe...

23 Sep 202024min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
nordnorsk-historie
abid-nadia-skyld-og-skam
rss-overskuddsliv
dekodet-2
tidlose-historier