Ever questioned the use of d-dimers for PE/DVT? Of course you have, if you’re in EM. For all those times you’ve wondered, this week Dr. Aman Shah will be leading an interesting discussion looking at “Saving Dimes and Sending Dimers”

 

 

For the time that 67 year old otherwise healthy woman comes in slightly short of breath and slightly tachy, making you worried about PE, but has no risk factors… Should you trust her age-adjusted D-dimer cutoff?

Righini, M., et al. (2014). “Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study.” JAMA 311(11): 1117-1124.

 

And when the thought didn’t initially cross your mind, but only later you wondered about PE in this lady, does re-sticking a patient increase the circulating d-dimer value? Read on, what do you think?

Heffner, A. and J. Kline (2001). “Role of the peripheral intravenous catheter in false-positive D-dimer testing.” Acad Emerg Med 8(2): 103-106.

 

Something extra to make you rethink ordering that extra blue top just in case…

Kochert, E., et al. (2012). “Cost-effectiveness of routine coagulation testing in the evaluation of chest pain in the ED.” Am J Emerg Med 30(9): 2034-2038.

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