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

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Podcast #256: Fentanyl Ingestion

Podcast #256: Fentanyl Ingestion

Authors: Don Stader, M.D & Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Fentanyl patches may be abused in many ways, including changing the patches more frequently, chewing them, extracting t...

2 Okt 20175min

Deep Dive #6: Bacteriuria and the Elderly

Deep Dive #6: Bacteriuria and the Elderly

Author: Heidi Wald, MD, MSPH Associate Professor of Medicine - University of Colorado School of Medicine, Physician Advisor - Colorado Hospital Association Dr. Heidi Wald explains common misconceptio...

25 Sep 201729min

Podcast #255: Posterior Vitreous Detachment

Podcast #255: Posterior Vitreous Detachment

Author: Erik Verzemnieks, M.D. Educational Pearls Posterior vitreous detachment is the tearing of the lining in the back of of the eye. Patients often present with loss of vision and floaters. Diagno...

22 Sep 20171min

Podcast #254: Myths About Antibiotic Course Length

Podcast #254: Myths About Antibiotic Course Length

Author: Chris Holmes, M.D. Educational Pearls There's little/no data about the necessary length of an antibiotic course, nor has it proven that stopping a course of antibiotics early selects for the ...

20 Sep 20174min

Podcast #253: Total Eclipse of the Eye - Solar Retinopathy

Podcast #253: Total Eclipse of the Eye - Solar Retinopathy

Author: Nick Hatch, M.D. Educational Pearls Photic or solar retinitis occurs when you stare at the sun. The refractive power of the lens of the eye concentrates the light of the sun on the retina, st...

18 Sep 20173min

Podcast #252: Mandible Fractures

Podcast #252: Mandible Fractures

Author: Sam Killian, M.D. Educational Pearls The tongue blade test is done for mandible fractures, which make up 40-60% of facial fractures. The test is done by having the patient bite down on a tong...

15 Sep 20174min

Podcast #251: Cyanide Poisoning

Podcast #251: Cyanide Poisoning

Author: Rachel Beham, PharmD, Advanced Clinical Pharmacist – Emergency Medicine Educational Pearls Cyanide poisoning is suspected in patients who present with lactic acidosis after being trapped arou...

13 Sep 20174min

Podcast #250: Desmopressin

Podcast #250: Desmopressin

Author: Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Desmopressin is an ADH mimetic and helps retain water, release von Willibrand Factor (in high doses), and treat diabetes insipidus (in low...

11 Sep 20173min

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