#92: Pulmonary Embolism for the Internist

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 23 April 2018

⏱️ 57 minutes

🔗️ Recording | iTunes | RSS

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Summary

Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

5:10 - Start of Interview / Introduction
10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
28:45 - What does a low-risk patient look like?
30:35 - When to consider treatment modalities other than general anticoagulation
35:12 - Anticoagulation treatment options
36:38 - Next step intensive interventions after anticoagulation
42:00 - Evidence behind catheter-directed lysis
44:05 - IVC Filter discussion
47:22 - Discharge criteria for PE
50:00 - Incidental PEs
52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

Transcript

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0:00.0	The first Irish podcast is for entertainment education and information process only.
0:09.2	And the topics discussed should not be used only by industry, your orbit and industry is more
0:11.6	conditioned.
0:12.6	For more of the views and interests on this podcast are soloed to those who should not be
0:14.1	interpreted perfectly for official post-election of the agency, the psychrompossil,
0:16.0	cash-like morons will end affiliate outreach programs.
0:17.3	Indeed, there are any back there, none.
0:18.3	Pretty much we are responsible for this throughout, but you should always do your homework
0:20.3	and let's know when we're ready.
0:30.0	Welcome back to the curbsiders.
0:37.0	Well, hello.
0:38.0	Hello Stewart.
0:39.0	Hi.
0:40.0	It Paul's not here, so we do have some co-hosts tonight and I'll let Chris, why don't you introduce
0:47.2	yourself first.
0:48.2	I'm Chris Chu, the resident med-peads guy on the podcast.
0:53.0	Yeah, but you're not a resident, you're an attending physician.
0:55.4	I'm not a resident.
0:56.4	The attending med-peads guy on the podcast.
1:00.4	Okay.
1:01.4	And I'm at cash-like...
1:02.4	As he's dancing on camera.
	...

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