August 2017

Idarucizumab Works – At Least in the Lab

Idarucizumab reverses anticoagulation 100% due to dabigatran in the test tube. It seemed to stop active bleeding in patients in about 2.5 hours, and reported operative hemostasis was good.  But since this was an open label trial with no control group, we don’t know how the outcomes would have compared with patients who were treated with other procoagulants or who were not treated.

Should We Be Doing ED Stress Tests?

ED stress testing, in addition to standard workup with ECG and biomarkers, led to more downstream testing (angiography) and more interventions (PCI or CABG), but this didn’t translate into fewer acute myocardial infarctions at one year.

Clearing Drunk C-spines

A negative c-spine CT had 99.9% NPV for clinically significant c-spine injury in intoxicated patients.  The Western Trauma Association recommends c-spine clearance, even in intoxicated patients, if gross motor function is normal, no neurologic complaints, and negative c-spine CT per experienced radiologist.  Be careful out there, and get institutional buy-in if you plan to put this into practice.

A Kinder Simpler Geneva Score

A simplified Geneva Score is safe to use in place of the Geneva score and is straightforward, with each criterion being worth one point.  Low to Intermediate pretest probability plus negative D-dimer with the simplified Geneva ruled out PE as well as the regular Geneva score.

Scroll to Top