Archive for category: Pulmonary

Simplifying Mechanical Ventilation – Part I: Types of Breaths

08 Mar
March 8, 2018

Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of the basic concepts of mechanical ventilation because without it, we can do serious harm to our patients. Airway management […]

Is it PROPER to PERC it Up?

19 Feb
February 19, 2018

Background: The diagnosis of PE is a tricky thing.  We want to limit over-testing patients and therefore, over-diagnosis. On the other hand, we don’t want to limit testing so much that we miss the diagnosis where treatment would make a difference.  The pulmonary embolism rule-out criteria (PERC) was created to reduce testing in patients who […]

The Critical Pulmonary Embolism Patient

06 Nov
November 6, 2017

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 ACOEP 2017 again with an update on the critical pulmonary embolism patient. This post will serve as a reference for that talk. There are many ways to classify pulmonary […]

The YEARS Study – Simplified Diagnostic Approach to PE

28 Sep
September 28, 2017

Background: The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, requiring dependence on objective testing. Decision instruments such as PERC and the Wells’ score help stratify patients to low or high probability, enabling focused use of CT pulmonary angiography (CTPA) for diagnosis. However, despite these algorithms, there is evidence of increasing […]

Safety of PE Treatment with Rivaroxaban

31 Aug
August 31, 2017

Background: The simplified PE Severity Index (sPESI) is one of several validated prognostic tools for acute pulmonary embolism (PE).  The European Society of Cardiology recommended the use of the sPESI to risk-stratify patients with acute PE into low risk (sPESI=0) and non-low risk (sPESI≥1) in order to guide treatment and disposition (Konstantinides 2014).  Systematic reviews and […]