>From: Rowley Cottingham <[log in to unmask]>
>Reply-To: Accident and Emergency Academic List <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: diagnosis and Rx of pulmonary embolism
>Date: Tue, 7 Sep 2004 19:29:00 +0100
>
> > Let us assume a decision was made to further investigate this young
> > patient
> > to rule out pulmonary embolism, how would you manage her
> > anticoagulation in
> > the ED?
> >
> > John Black
> > Oxford
>
>DVT and PE is a terrible disease. Once you have one DVT you are likely
>to suffer damage to the deep venous system of the leg as the clot
>organises.
>
>Having treated a patient with a PE and seeing her transformed from
>moribund to quite well I believe that the correct treatment for DVT
>should be thrombolysis. It is incredibly effective on pure clot, which a
>DVT is. It is only 30% effective in acute myocardial infarction.
>
>
>
>Rowley Cottingham.
I would second that whole heartedly!As is reported, thrombolysis can double
the likelihood of achieving a normal venogram and normal lower extremity
physiologic function with reduction of recurrent DVT by 50% and reduction of
crippling post-phlebitic syndrome by 70%!!Similar success with even stable
pulmonary embolism.
Ayan
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