Understanding Medical Technologies
Diagnosing PE in Pregnant Women — Brown Emergency Medicine
Epidemiology – Venous thromboembolism (VTE) occurs in pregnant women at 7-10 times the incidence in age-matched controls. Pregnant women who get VTE have deep venous thrombosis (DVT) approximately 3 times as often as pulmonary embolism (PE). The increased risk is similar during all three trimesters, starts to diminish after delivery, and returns to baseline by six weeks post-partum. The left leg is affected in 85% of pregnancy-associated DVT, possibly from compression of the left iliac vein. Isolated pelvic DVT is also more common in pregnancy. In the developed world, pregnancy-associated VTE is the leading cause of maternal mortality.
Source: Diagnosing PE in Pregnant Women — Brown Emergency Medicine
JAMA Cardiology – Effect of the Presence and Type of Angina on Cardiovascular Events in Patients Without Known Coronary Artery Disease Referred for Elective Coronary Angiography
This study describes the characteristics of patients referred for typical, atypical, or no angina and examines the associations between angina type, pre–cardiac catheterization stress test results, and burden of coronary atherosclerosis identified on coronary angiography.
In this short research letter we find further lack of utility for stress tests in the manner for which we are currently using them for risk stratification. The authors categorized patients referred for catheterization without known CAD to groups based on chest pain symptoms of: typical, atypical, or absent. They then looked at their stress test results, categorized as positive or negative, and found that a negative stress test did not help predict those without obstructive CAD on catheterization. Specifically, patients with typical angina symptoms and a negative stress test were the MOST likely to have obstructive CAD (74%). Clearly limited by the nature of the data presented, and the limited information given regarding the methodology in this research letter, it does further raise doubts regarding the utility of stress testing to risk stratify patients for CAD.
HT to Jeremy Fried for the observation quoted above. Source: Research and Reviews R&R in the FastLane | LITFL: Life in the Fast Lane Medical Blog
Didn’t Take That IVC Filter Out? Consider IVC Thrombosis – Medpage Today
Another reason to ‘pull it out as soon as is safe and reasonable’
Source: Didn’t Take That IVC Filter Out? Consider IVC Thrombosis | Medpage Today
Alternative Dementia Screening Tests | Physician’s Weekly
Alternative Dementia Screening Tests | News Brief
October 7, 2015
Source: Alternative Dementia Screening Tests | Physician’s Weekly
Ultrasound of the Week | UOTW #36
Ultrasound of the Week | UOTW #36.
Emergency physicians can be trained to identify these lesions with good accuracy. A study by Kerwin et al found that after a brief, 30 minute training module, median percentages correct improved from 67% to 87% when reviewing pre-recorded clips.
I’m at a loss to explain why I like looking at ultrasounds. I guess I’m simply fascinated that some people can actually know and understand what they’ looking at. My physician in the family says it’s a matter of numbers. The more you look at, the better you get.
Underwriters will find the answer and pearl section more useful.
Is Coronary CT Worth It? The FOAMed Report – Medpage Today
Enterobacteriaceae! 2 deaths at UCLA hospital; 179 potentially exposed – LA Times
Superbug linked to 2 deaths at UCLA hospital; 179 potentially exposed – LA Times.
“This bacteria is emerging in the U.S. and it’s associated with a high mortality rate,” Kallen said in an interview. “We don’t want this circulating anywhere in the community.”
What it Looks Like: Cardiac Arrest | EMS 12 Lead
What it Looks Like: Cardiac Arrest | EMS 12 Lead.
See header.
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