UMEM Educational Pearls

Pulmonary Embolism 

  • In patients with high pretest probability and abnormal vital signs think about cardiac evaluation for pulmonary embolism. McConnell’s sign is most specific but can also be found in acute RCA infarct. TAPSE < 1.8 cm is also a good identifier of RV strain. Remember that patients with COPD or Pulm Htn may have RV dilation at baseline. You may also want to risk stratify patients with PE with labs as well as lower extremity dvt studies. 
  • Let’s give a shout out to Ashley Pickering who recently took some awesome echo images of a patient with a known saddle embolism. 

 

Show References



Title: Injury score comparable geriatric vs non-geriatric patients: Over 65 years do much worse

Category: Trauma

Keywords: geriatric, trauma, orthopedic injury, injury severity score (PubMed Search)

Posted: 11/5/2022 by Robert Flint, MD (Updated: 12/9/2022)
Click here to contact Robert Flint, MD

Trauma patients over age 65 should be cared for by a multidisciplinary trauma team. Here is another study affirming that patients over age 65 do worse when having similar injuries to those under 65. Interestingly, those under 65 had more operative repairs of their orthopedic injuries as well.  

The authors conclude: “Although the ISS and NISS were similar, mortality was significantly higher among patients aged ≥ 65 years compared to patients < 65 years of age”.

 Also it bears further investigation of why those under 65 received more operative repairs

 

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