Im amazed some of you wouldnt scan this woman. It must be a southern
hemisphere thing - I certainly would have scanned her.
You all seemed to want to scan my UTI/Ectopic lady last week but not this
lass :-) - by the way she did have an ectopic and also a UTI (heavy e-coli
growth) - she presented 13 days later with a ruptured ectopic and the
complaint is St Elsewhere had failed to diagnose it - and she was completely
symptom free for 10 days after her UTI was treated - midwife didnt arrange a
scan - then severe abdo pain and syncope.
We use Well's Likely / Unlikely risk stratification rather than low, medium
or high and she would have fallen into the likely cat (>4) which is an
urgent CTPA - protocol agreed with radiology - after 10pm anticoagulate and
they do it the next morning.
Craig
Back in NZ from Perth, and in Sunny (but bloody cold) Hawkes Bay with a 90%
English SHO workforce !!
>From: Ayan Sen <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: diagnosis of pulmonary embolism
>Date: Thu, 2 Sep 2004 04:06:09 +0530
>
>You're right,Andy.....precisely the point,do agree about the mortality and
>problems with angio and warfarin...in fact,even angio has missed PE(pleural
>infarcts)....but how do u assess the low probability if no alternative
>diagnosis is definite?that in itself puts 3 point score and a moderate
>probability where d-dimers are not supposed to have any relevance.
>
>Ayan
>
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