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EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Near-Drowning, Polio, Head-up CPR
by Anton Helman
Sep 13, 2022
In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain man...
Tactical Medicine News
VTE Recurrence in Subsegmental PE: What’s the Risk?
Background: The overall mortality and case-fatality rate for pulmonary embolism (PE) are decreasing. Yet reporting is increasing, suggesting we are...
Tactical Medicine News
The INSPIRATION Trial: Intermediate Dose Anticoagulation in Critically Ill Patients with COVID-19
Background: COVID-19 infection increases the risk of thrombosis due to multiple factors.(Rico-Mesa, 2020). Over the last 2 years, researchers hav...
Tactical Medicine News
ECG Cases 29 Misdiagnosis from Lead Misplacement, Artifact and Lead Reversal
In this ECG Cases blog we review 10 cases of possible artifact, lead reversal and lead misplacement. Can you spot the abnormalities and avoid the m...
Tactical Medicine News
The Pragmatic Combination of YEARS Score and Age-Adjusted D-Dimer
Background: The optimal approach to risk stratifying patients for pulmonary embolism (PE) remains elusive. Multiple decision instruments are availa...
Tactical Medicine News
The HEP-COVID Trial: Therapeutic Anticoagulation in Non-Critically Ill COVID-19 Patients
Background: Patients with COVID-19 are at increased risk from thromboembolic phenomena. Patient-specific factors such as comorbidities and immobili...
Tactical Medicine News
Rebellion21: Not Your Gallbladder – Clutch US Diagnoses in RUQ Pain via Jennifer Carnell, MD
In this 17-minute presentation from Rebellion in EM 2021, Dr. Jennifer Carnell, MD demonstrates how ultrasound can be used to make a diversity of d...
Tactical Medicine News
EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine
In this month's EM Quick Hits podcast, Anand Swaminathan on tips and tricks in polytrauma, Rohit Mohindra on diagnosis and management of toxic mega...
Tactical Medicine News
ECG Cases 26: Pulmonary Embolism and Acute RV Strain
In this month's ECG Cases Dr. Jesse McLaren runs through 10 cases and explains how the ECG can be integral in the diagnosis and management of pulmo...
Tactical Medicine News
ECG Cases 8 Cardiovascular Emergencies During The COVID-19 Pandemic
In this ECG Cases blog we look at 6 patients who presented with cardiorespiratory symptoms, possibly from COVID and illustrate the dangers of ancho...
Tactical Medicine News
PEGeD Study – Is It Safe to Adjust the D-Dimer Threshold for Clinical Probability?
Background: The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, thus requiring dependence on obje...
Tactical Medicine News
EM Quick Hits 7 Approach to Status Epilepticus, Codeine Interactions, Anticoagulation in Malignancy, Atrial Fibrillation Rate vs Rhythm Control, Peripheral Vasopressors, Motivational Interviewing
Anand Swaminathan on a simple approach to status epilepticus, David Juurlink on codeine and tramadol interactions: nasty drugs with nastier drug in...
Tactical Medicine News
The True Prevalence of PE in ED Syncope Patients
Background: Syncope, defined as a transient loss of consciousness with a complete recovery, is a common ED presentation. There are numerous causes ...
Tactical Medicine News
EM Cases Best of 2018 Top 10
2018 was the most successful year in EM Cases 9 year history with 1,777,303 podcast downloads reaching a total download count of nearly 8 million t...
Tactical Medicine News
LMWH in Cancer-Related VTE (CLOT Study)
Background: Venous thromboembolism (VTE) occurs frequently in patient with cancer. Treatment in this group entails a number of challenges including...
Tactical Medicine News
Edoxaban in Cancer-Associated VTE
Background: Venous thromboembolism (VTE) occurs frequently in patient with cancer. Treatment in this group entails a number of challenges including...
Tactical Medicine News
POCUS Cases Video Series has Launched!
The long wait has been well worth it. The EM Cases POCUS Cases Video Series has officially been launched!
POCUS Cases is an original EM Cases video...
Tactical Medicine News
The Critical Pulmonary Embolism Patient
Background: Previously, I had given a talk on the use of thrombolytics in submassive PE in 2016. This year, I had the privilege of speaking at ACOE...
Tactical Medicine News
The YEARS Study – Simplified Diagnostic Approach to PE
Background: The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, requiring dependence on objective...
Tactical Medicine News
Safety of PE Treatment with Rivaroxaban
Background: The simplified PE Severity Index (sPESI) is one of several validated prognostic tools for acute pulmonary embolism (PE). The European ...
Tactical Medicine News
Altitude Adjusted PERC Oxygen Saturation
The PERC rule has been a welcome addition to the emergency department evaluation of patients with chest pain or dyspnea suspected of pulmonary embo...
Tactical Medicine News
Normalization of Vital Signs Does Not Reduce the Probability of Pulmonary Embolism
Background: In patients with symptoms of pulmonary embolism (PE), we often turn to vital signs, including heart rate, respiratory rate and pulse...
Tactical Medicine News
The PEAPETT Trial: Half Dose tPA for PEA due to Massive Pulmonary Embolism
Background: Anyone who has run a code, knows that pulseless electrical activity (PEA) during cardiac arrest has a worse prognosis compared to patie...
Tactical Medicine News
Should I Stay or Should I Go: Outpatient Treatment of Venous Thromboembolism
Background: The care of venous thromboembolism (VTE) is currently undergoing a paradigm shift in the US with an increasingly large percentage of pa...
Tactical Medicine News
Treatment of Submassive Pulmonary Embolism (PE): Full Dose, Half Dose, or No Dose?
Submassive pulmonary embolism (PE) is responsible for approximately 20% of all PEs. Although the in-hospital mortality has been reported as about ...
Tactical Medicine News
REBEL Cast Episode 30: The PESIT Trial – Do All Patients with 1st Time Syncope Need a Pulmonary Embolism Workup?
Background: Syncope is a very frustrating chief complaint for many in the medical field. There is no gold standard test and no validated decision ...
Tactical Medicine News
Best Case Ever 44 Low Risk Pulmonary Embolism
Dr. Salim Rezaie of R.E.B.E.L. EM tells his Best Case Ever of a Low Risk Pulmonary Embolism that begs us to consider a work-up and management plan ...
Tactical Medicine News
Catheter Directed Thrombolysis: The Magic Bullet for Submassive Pulmonary Embolism?
Background: When evaluating therapeutic options for PE, there are three categories in my mind: Subsegmental, Submassive, and Massive. For simplicit...
Tactical Medicine News
Update on Age-Adjusted D-Dimer
D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. more false positive tests) in older patients. The result of ...
Tactical Medicine News
Rivaroxaban for Treatment of Symptomatic Pulmonary Embolism
Typically, the treatment of acute pulmonary embolism consists of administration of unfractionated heparin or low molecular weight heparin (i.e. eno...
Tactical Medicine News
Age Adjusted D-Dimer Testing
D-dimer testing is sensitive for thrombus formation, and in patients who are not high risk, this test is used to rule-out venous thromboembolism. D...
Tactical Medicine News
Diagnosis of Right Ventricular Strain with Transthoracic Echocardiography
Abnormal vital signs are poor predictors of mortality associated with pulmonary embolism (PE). Diagnosis of PE and right ventricular (RV) strain w...
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