Archive

Author: Anand Swaminathan

Is the D-Dimer Useful in High-Probabilty Pulmonary Embolism?

Bottom Line Up Top: A negative D-Dimer likely excludes significant pulmonary embolism (PE) in all patients but the low chance of getting a negative result makes a D-Dimer first approach of low clinical utility in the high pre-test probability ...

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Cardiovascular

Clinical Conundrum: Do I Have to Replace the Nail After an Avulsion?

Bottom Line Up Top: Replacing the nail into the eponychial fold doesn’t appear to be critical to nail regrowth and  cosmetic outcomes of finger injuries with nail avulsion. Clinical Scenario: A 6-year-old boy presents to the Peds ED with an ...

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Trauma

REBEL Core Cast 133.0 – TMJ Dislocation

Take Home points: Atraumatic TMJ dislocations are typically anterior in nature and can be reduced by a variety of techniques in the ED Traumatic TMJ dislocations often involve mandible fractures and typically require open reduction and fixation in the operating ...

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Head, Eye, Ear, Nose, and Throat

Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?

Bottom Line Up Top: There doesn’t appear to be a morbidity or mortality benefit to treating fever in sepsis and fever may have a protective effect. Only treat fever if it causes the patient distress. Clinical Scenario: A 45-year-old woman ...

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Infectious Disease

REBEL Core Cast 132.0 – Recent-Onset AFib

Take Home points: If the patient is low risk with CHA2DS2-VASc (men < 2, women < 3), cardioversion is safe up to 48 hours from onset. In higher risk patients, we should reserve cardioversion unless there is clear onset less ...

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