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Diagnostic approach to pulmonary embolism in a rural emergency department.
MedLine Citation:
PMID:  22188622     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Introduction: Pulmonary embolism (PE) is a serious condition with mortality estimates of up to 10%. We sought to investigate the diagnosis of PE, time to access imaging and diagnostic utility of each modality in a rural emergency department (Ed). Methods: We completed a retrospective chart review to determine the investigations performed and treatments initiated in the management of suspected PE in a rural hospital. Results: A total of 47 charts from a 5-year period were reviewed. Of these, 83.0% indicated a D-dimer test was ordered, and 31.9% and 40.4% indicated either ventilation-perfusion (V/Q) or computed tomography (CT) were ordered during the ED visit. Computed tomography diagnosed 11 of the 12 instances of confirmed PE. Mean time to patients undergoing V/Q or CT was 1.58 and 1.59 days, respectively. Low-molecular-weight heparin was started in 83.0% of patients. Conclusion: In this ED there may be over reliance on the D-dimer test, irrespective of Wells score. Access to V/Q and CT were similar to that of an urban centre. Empiric anticoagulation was started in most patients.
Authors:
Mike Ballantine; Munsif Bhimani; W Ken Milne
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada     Volume:  17     ISSN:  1488-237X     ISO Abbreviation:  Can J Rural Med     Publication Date:  2012  
Date Detail:
Created Date:  2011-12-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708550     Medline TA:  Can J Rural Med     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  17-20     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, University of Western Ontario and South Huron Hospital Association, Exeter, Ontario.
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