Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner

Journal Jam 1: Age Adjusted D-dimer with Jeff Kline and Jonathan Kirschner

In this first ever episode of the Journal Jam podcast, a collaboration between EM Cases, Academic Life in EM and The Annals of Emergency Medicine's Global Emergency Medicine Journal Club, Teresa Chan and I, along with Jeff Kline, Jonathan Kirschner, Anand Swaminathan, Salim Rezaie and Sam Shaikh from ALiEM, discuss the potential for Age Adjusted D-dimer to rule out pulmonary embolism in low risk patients over the age of 50. We discuss 4 key questions about the ADJUST-PE Study from JAMA in March 2014 including: Would you order a CTPA on a 60 year old woman with an age adjusted D-dimer of 590 ng/L? The problem until now has been that the older the patient, the more likely the D-dimer is to be positive whether they have a PE or not, so many of us have thrown the D-dimer out the window in older patients and go straight to CTPA, even in low risk patients. If you are a risk averse doc, this strategy will lead to over-utilization of resources, huge costs, length of stay, radiation effects etc; and if you’re not so risk averse, then you might decide not to work up the low risk older patient at all and miss clinically important PEs. expert peer reviewFor all the questions discussed on this podcast, the original Google Hangout interview from which this podcast was based, and the crowd sourced opinions from around world, visit the ALiEM website. Many thanks to all the talented people who made this podcast possible. Together, we're smarter!

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Episoder(399)

Ep 220 Facial Injuries: Assessment, Management and Disposition

Ep 220 Facial Injuries: Assessment, Management and Disposition

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30 Jun 1h 43min

Ep 219 Hip Emergencies: Recognition and Management

Ep 219 Hip Emergencies: Recognition and Management

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16 Jun 1h 25min

Journal Jam 24 Antibiotics for Strep Throat: Evidence, Myths and Misperceptions

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2 Jun 1h 19min

Ep 218 Substance Use Disorder in the ED – Stigma, Compassion and System Change

Ep 218 Substance Use Disorder in the ED – Stigma, Compassion and System Change

Emergency physicians pride themselves on recognizing and treating life-threatening illness under pressure. Yet one of the most lethal, common, and treatable conditions presenting to our EDs still ofte...

19 Mai 1h 1min

Ep 217 Pediatric Agitation: Assessment and Management

Ep 217 Pediatric Agitation: Assessment and Management

Pediatric agitation in the Emergency Department is one of those presentations that can escalate quickly and leave even experienced clinicians feeling on edge. It is high-risk, resource-intensive, and ...

28 Apr 1h 22min

Ep 216 Cardiac Arrest Update: Beyond the 2025 ACLS Guidelines Part 2 – Medications, Airway, Termination and Post-ROSC Care

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In this Part 2 or our 2-part EM Cases podcast series on Cardiac Arrest Update, Dr. Sheldon Cheskes and Dr. Rob Simard take us beyond the algorithms and into the real-world decision-making of cardiac a...

7 Apr 1h 41min

Ep 215 Cardiac Arrest Update: Beyond the 2025 Guidelines Part 1: CPR, Defibrillation and Ventilation

Ep 215 Cardiac Arrest Update: Beyond the 2025 Guidelines Part 1: CPR, Defibrillation and Ventilation

In this EM Cases update on cardiac arrest management, Dr. Sheldon Cheskes and Dr. Rob Simard join Anton to walk us through the evolving science and bedside practicalities of cardiac arrest management ...

25 Mar 1h 52min

EM Quick Hits 71 EMC²: Fever Without a Source, Coaching the EM Mind Part 1, Traumatic Pneumothorax Part 2, PECARN C-spine Rule, Medetomidine Withdrawal, EMS Handover

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10 Mar 1h 38min

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