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(1145)

Podcast 716: Resuscitation Fluids

Podcast 716: Resuscitation Fluids

Contributor: Nick Tsipis, MD Educational Pearls: Fluid choice may have an impact on outcomes in resuscitation, and a meta-analysis has relevant insight into their use in sepsis and trauma patients La...

29 Sep 20214min

Podcast 715: Heated High Flow O2

Podcast 715: Heated High Flow O2

Contributor: Nick Hatch, MD Educational Pearls: High flow nasal cannula (HFNC) or "heated high flow" can deliver higher oxygen levels than nasal cannula It typically is used as an "intermediate" betw...

27 Sep 20214min

Podcast 714: Intradermal Sterile Water for Back Pain

Podcast 714: Intradermal Sterile Water for Back Pain

Contributor: Aaron Lessen, MD Educational Pearls: Randomized controlled-trial evaluated intradermal injections of sterile water to manage low back pain versus an IV NSAID Four intradermal injections ...

21 Sep 20213min

Podcast 713: Oral Ketamine

Podcast 713: Oral Ketamine

Contributor: Don Stader, MD Educational Pearls: Those on chronic opioid therapy may have high tolerance to opioids and/or opioid hyperalgesia Ketamine is a good adjunct for pain control in patients o...

20 Sep 20213min

Podcast 712: Cephalosporin with a Penicillin Allergy

Podcast 712: Cephalosporin with a Penicillin Allergy

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study in the Kaiser system looked at over 4 million patients receiving antibiotics to determine the effect of penicillin allergy...

13 Sep 20213min

On the Streets #10: IO Administration Gone Awry

On the Streets #10: IO Administration Gone Awry

Dr. Glenda Quan, trauma surgeon from Swedish Medical Center joins our host Jordan Ourada to review a case of an incorrectly placed IO and how to avoid it. The Emergency Medical Minute is excited to an...

8 Sep 202115min

Podcast 711: Insulin Pumps

Podcast 711: Insulin Pumps

Contributor: Aaron Lessen, MD Educational Pearls: Insulin pumps provide a continuous infusion of fast-acting insulin using a basal rate and bolus prior to meals Some connect to a continuous glucomete...

7 Sep 20214min

Podcast 710: Droperidol vs. Zyprexa

Podcast 710: Droperidol vs. Zyprexa

Contributor: Nick Tsipis, MD Educational Pearls: Prospective trial studied 5 mg IM droperidol to 10 mg IM olanzapine (Zyprexa) in the reducing levels of agitation Time to adequate sedation was about ...

31 Aug 20215min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
sexet
rss-spraket
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
vetenskapsradion
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
bildningspodden