Author Archives: plw6y

1. Age Adjusted D-Dimer in PE Rule Out

 Practice Change: An age adjusted d-dimer cut off for PE evaluation is a safe and effective way to evaluate patients over 50 years old for PEs.  I think we should talk to the lab about changing how we report our … Continue reading

Posted in *PRACTICE CHANGING, Pulmonology | Tagged , ,

2A, 2B: Tranexamic Acid and CRASH-II

Practice Change: If Tranexamic Acid is not on your short list of life saving medications in trauma, it should be!  It is inexpensive and has a mortality benefit in hemorrhaging trauma with a NNT of 67 to save a life.   … Continue reading

Posted in *PRACTICE CHANGING, Trauma | Tagged , ,

2C. TXA in Head Injury?

What About Use In Head Injuries? Take Home: Our system’s trauma protocol suggests stopping TXA once there is a head injury discovered, BUT given this data, I wouldn’t be too worried that we had caused harm in the patient by … Continue reading

Posted in Trauma | Tagged , ,

2D. TXA in Mature Trauma System

Take Home: TXA works in an established trauma system. – Annals of Surgery 2015 Study: Prospective Observational Cohort done in England of patients while their trauma system initiated use of TXA therapy in their Massive Transfusion Protocols Patients: Trauma patients … Continue reading

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2E. Military TXA Studies – TXA looks good in multiple settings.

Military Studies  Take Home: TXA seems effective in multiple settings and multiple studies. There are several other studies evaluating TXA in a military setting. TXA does seem effective in these studies as well, but because the protocols are different and they … Continue reading

Posted in Trauma | Tagged , ,

EM ONE – June 2015 Still Up All Night – Urology Dogma Challenge Especiale!

Kidney Stone Dogma Challenge Here is the June Late Night Lit Review. There have been several good, potentially practice changing, articles on the management of kidney stones in the last year. I decided to do a deep dive on the … Continue reading

Posted in Monthly THUMBNAIL

1. US for Kidney Stones is Safe and Effective

Practice Change: In patients I suspect of having renal colic, an US will be my first imagining study.   I can always get a CT later if I’m not satisfied with the workup. I may talk to the patients about possible … Continue reading

Posted in *PRACTICE CHANGING, Urology | Tagged , ,