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

Avsnitt(1147)

Podcast #203: Wine, Milk and… Vaccines!?

Podcast #203: Wine, Milk and… Vaccines!?

Author: Dave Rosenberg M.D. Educational Pearls: Louis Pasteur developed the technique that is now known as pasteurization. It was first used in the wine-producing regions of France, and eventually in...

12 Maj 20174min

Podcast #202: Tide Pods

Podcast #202: Tide Pods

Author: Susan Brion M.D. Educational Pearls: Laundry and dishwasher detergent pods resemble candy and can be ingested by children. These tide pods are very highly concentrated and can cause chemical ...

10 Maj 20173min

Podcast #201: Task Interruption

Podcast #201: Task Interruption

Author: Mark Kozlowski M.D. Educational Pearls: Humans cannot "multitask" effectively - a more accurate term is "task interruption." When doing more than one task at once, we are more likely to forge...

8 Maj 20173min

Podcast #200: Non-traumatic Back Pain

Podcast #200: Non-traumatic Back Pain

Author: Don Stader M.D. Educational Pearls: Non-traumatic back pain is a very common complaint in the Emergency Department. Conditions that can manifest with back pain include: ruptured abdominal aor...

6 Maj 20172min

Podcast #199: Prolonged QT with Zofran

Podcast #199: Prolonged QT with Zofran

Author: Arthur Lessen M.D. Educational Pearls: Zofran (ondansetron) is generally safe to use for the treatment of nausea and vomiting. However, it can prolong the QT interval and increase the chance ...

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Podcast #198: Imodium

Podcast #198: Imodium

Author: Aaron Lessen M.D. Educational Pearls: Imodium (loperamide) is a mu-opioid receptor agonist. Traditionally, it is used as an anti-diarrheal. It is also abused recreationally for an opioid high...

2 Maj 20173min

Podcast #197: Ashman Phenomenon

Podcast #197: Ashman Phenomenon

Author: Dylan Luyten M.D. Educational Pearls: Ashman's Phenomenon occurs in the setting atrial fibrillation and mimics ventricular tachycardia, but is harmless. On ECG, the pattern of Ashman Phenomen...

30 Apr 20171min

Podcast #196: DVT and May-Thurner Syndrome

Podcast #196: DVT and May-Thurner Syndrome

Author: Samuel Killian M.D. Educational Pearls: Lower extremity DVTs are extremely common. There are more left lower extremity DVT due to anatomical variation. May-Thurner Syndrome is a form of anato...

28 Apr 20172min

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