Archive

Medical Category: Thoracic and Respiratory

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 embolism. This has allowed a reduction in D-dimer testing in low risk patients. The traditional saturation cut-off of ...

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Thoracic and Respiratory

The Benefit of Lung Protective Ventilation in the ED Should be LOV-ED

Background: Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the ...

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Thoracic and Respiratory

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 oximetry, as part of our initial impression of the patient.  Before even considering further testing, such as d-dimer or ...

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Thoracic and Respiratory

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 5%, there is significant morbidity associated with this diagnosis such as chronic pulmonary hypertension, impaired quality of life, persistent ...

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Thoracic and Respiratory

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 instrument. It represents about 3 – 5% of ED visits, 1 – 6% of hospital admissions, ...

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Thoracic and Respiratory
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