Point-of-Care Ultrasound for Submassive Pulmonary Embolism

Pulmonary embolism (PE) is a common and potentially fatal diagnosis that must be considered in the emergency department (ED) setting in patients presenting with chest pain or shortness of breath. PE accounts for approximately 100,000 deaths annually in the United States and, according to some studies, this rate is increasing (1). Although computed tomography pulmonary angiography (CTPA) is the gold standard imaging modality for the diagnosis of PE, point-of-care ultrasound (POCUS) is often more readily available and can be used to quickly obtain critical information regarding global cardiac function and direct management.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research

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Compared to others, those with a spouse in the ICU had increased odds of an event such as chest pain, heart attack, stroke, irregular heart rhythm, heart failure or a blood clot in the lungs (pulmonary embolism) within a month.
Source: WebMD Health - Category: Consumer Health News Source Type: news
In patients that require oral and maxillofacial surgery, the risk vs benefits of incorporating appropriate anticoagulation prophylaxis used to prevent deep vein thrombosis (DVT) needs to be further studied as clear guidelines are not established. DVT can be found in up to 50% to 80% percent of trauma patients, depending on the mechanism of injury, leading to a multitude of complications from localized pain to fatal pulmonary embolism.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Plastic and maxillofacial surgery Source Type: research
Authors: Takeuchi M, Okada T, Iwato K, Kawamoto K, Ikegami Y, Nakamoto Y, Idei N, Ohashi N Abstract A 55-year-old man treated with polycythemia vera visited our hospital, complaining of left abdominal pain and dyspnea. He had received minocycline infusions three weeks earlier for mycoplasma pneumonia. Contrast-enhanced computed tomography revealed pulmonary embolism and splenic infarction. Ultrasonography of the vein in the forearm revealed a thrombus filling the distal brachial veins to the radial veins on both sides. His condition improved after anticoagulant therapy, and right and left shunts were detected on tr...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusion: This trial would provide an evidence for the use of different types of peripheral nerve blocks in TKR.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
An 18 year old complained of chest pain.Here is his ECG:  What do you think?Comment on ECGMany immediately think this is pericarditis.  But, in fact, this is the patient's baseline early repolarization, seen on a previous ECGs when he presented for a seizure (not chest pain). Most diffuse ST elevation is normal variant.  --There isdiffuse ST Elevation.  --There are well-formednotchesat the J-point in all leads with ST Elevation.  The STE is called normal variant.  The notching qualifies the ECG as true early repolarization (which is now defined as distinct from normal varia...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Objective: The clinical presentation of pulmonary embolism (PE) can be various and misleading. We analysed patients with suspicion of PE and subsequently performed computed tomography pulmonary angiography (CTPA) in an emergency department of Internal Medicine, focusing on patient groups in which PE might be underestimated in the emergency setting, such as young patients and patients with low clinical probability. Material and Methods: In 2016 and 2017, all patients receiving a CTPA for the question of PE were retrospectively evaluated for clinical (age, symptoms, vital parameters) and D-Dimers. The Wells score was calcul...
Source: Medical Principles and Practice - Category: Internal Medicine Source Type: research
Conclusion: Among patients presenting to emergency department with chest pain, 30% had a workup for pulmonary embolism. We report five clinical variables independently associated with a higher probability of pulmonary embolism workup in our sample.
Source: European Journal of Emergency Medicine - Category: Emergency Medicine Tags: Original Articles Source Type: research
CONCLUSIONS: Mini-open lateral retropleural and retroperitoneal corpectomies can safely achieve anterior column reconstruction and spinal deformity correction for various thoracic and thoracolumbar vertebral pathologies. PMID: 32871570 [PubMed - in process]
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
In this study, except for troponin elevation,Gestalt was the best predictor.The article does not specify the QT correction methodWhy is right ventricular hypertrophy (RVH) not found in this large study of syncope?  Probably because it is not common enough to be identified in a general syncope study.  Not every high risk factor will be identified in such studies, but it is obvious that RVH is a dangerous condition and that, if identified on ECG, needs further workup.  Why were so few ECG findings predictive?Because most abnormal ECG findings were considered adverse outcomes in their own right and not eva...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion: The study will provide more evidence on the combination use of adductor canal block and local infiltration analgesia in the treatment of pain after the total knee arthroplasty. Trial registration: This study protocol was registered in Research Registry (researchregistry5832).
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
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