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 598: Sepsis, Round One

Podcast 598: Sepsis, Round One

Contributor: Aaron Lessen, MD Educational Pearls: Early antibiotics have been shown to improve outcomes in septic patients time after time Emerging evidence challenges the concept of one-size-fits-al...

22 Sep 20203min

Podcast 597: Weather Can be a Headache

Podcast 597: Weather Can be a Headache

Contributor: Sam Killian, MD Educational Pearls: One study found that patients presented with headaches more frequently when there was high temperatures and low humidity, while higher humidity is cor...

21 Sep 20202min

Pediatric Emergencies Brewcast: Pediatric Trauma

Pediatric Emergencies Brewcast: Pediatric Trauma

Emergency Medical Minute collaborated with CarePoint Health in early March for a night of education on Pediatric Emergencies at a local Denver brewery for our latest Brewcast. Pediatric patients requi...

16 Sep 202024min

Podcast 596: Peripheral Vasopressors

Podcast 596: Peripheral Vasopressors

Contributor: Aaron Lessen, MD Educational Pearls: Traditional teaching has shied away from using vasopressors through peripheral IVs Tissue necrosis from extravasation is cited as a risk of use of va...

15 Sep 20203min

Podcast 595: Smoking. Still Bad

Podcast 595: Smoking. Still Bad

Contributor: Don Stader, MD Educational Pearls: On average, smoking reduces life expectancy by 13.2 years for men and for 14.5 years for women Nicotine is highly addictive and has both stimulant and ...

14 Sep 20203min

On The Streets #8: Limb Injury and Preservation

On The Streets #8: Limb Injury and Preservation

Dr. Glenda Quan, esteemed Trauma Surgeon at Swedish Medical Center, discusses cases related to limb injury and reviews their management. Topics include proper tourniquet application as well as altern...

9 Sep 202024min

Podcast 594: Topicalization for Awake Intubations

Podcast 594: Topicalization for Awake Intubations

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Topical anesthetization can allow for an awake intubation, which substantially decreases chance of loss of airway or respiratory drive because ...

8 Sep 20203min

Podcast 593: TXA for GIB

Podcast 593: TXA for GIB

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Tranexamic acid (TXA) as shown to have mortality benefit to patients with traumatic GI hemorrhage but should it be used to achieve hemostasis i...

7 Sep 20202min

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