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Tag: Pulmonary Embolism

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 ACOEP 2017 again with an update on the critical pulmonary embolism patient. This post …

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Thoracic and Respiratory

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 testing. Decision instruments such as PERC and the Wells’ score help stratify patients to low or high probability, enabling focused use of …

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Thoracic and Respiratory

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 Society of Cardiology recommended the use of the sPESI to risk-stratify patients with acute PE into low risk (sPESI=0) and …

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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

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

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