Limits...
Emergency Physician Performed Ultrasound for DVT Evaluation.

Fox JC, Bertoglio KC - Thrombosis (2011)

Bottom Line: However, early implementation of treatment substantially improves the disease prognosis.Therefore, care must be taken to both acquire an accurate differential diagnosis for patients with symptoms as well as to screen at-risk asymptomatic individuals.However, limited availability of ultrasound technicians may result in delayed imaging or in a decision not to image low-risk cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Irvine Medical Center, University of California, 101 The City Drive South, Route 128-01, Orange, CA 92868, USA.

ABSTRACT
Deep vein thrombosis is a common condition that is often difficult to diagnose and may be lethal when allowed to progress. However, early implementation of treatment substantially improves the disease prognosis. Therefore, care must be taken to both acquire an accurate differential diagnosis for patients with symptoms as well as to screen at-risk asymptomatic individuals. Many diagnostic tools exist to evaluate deep vein thrombosis. Compression ultrasonography is currently the most effective diagnostic tool in the emergency department, shown to be highly accurate at minimal expense. However, limited availability of ultrasound technicians may result in delayed imaging or in a decision not to image low-risk cases. Many studies support emergency physiciansas capable of accurately diagnosing deep vein thrombosis using bedside ultrasound. Further integration of ultrasound into the training of emergency physicians for use in evaluating deep vein thrombosis will improve patient care and cost-effective treatment.

No MeSH data available.


Related in: MedlinePlus

DVT clinical algorithm suggested by the American College of Emergency Physicians (ACEP) [17].
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3211105&req=5

fig1: DVT clinical algorithm suggested by the American College of Emergency Physicians (ACEP) [17].

Mentions: CUS may be performed utilizing a whole-leg or 2-point strategy. In whole-leg CUS, both proximal and distal veins are evaluated. Two-point CUS only involves compression of the common femoral vein (CFV) and popliteal vein (PV) to their branching points. Studies have indicated that the whole-leg and 2-point strategies are equivalently effective in identifying DVT, and thrombi with potential to form PE are found in the CFV and/or PV. Therefore, emergency physicians should perform 2-point CUS and instruct patients with thrombi found distal to the popliteal vein, high pretest patients, and patients with positive D-dimer and negative CUS to consult their primary care physician and schedule a follow-up ultrasound within the week. In the event that a patient is unable to consult a physician in the necessary time frame, they should return to the ED within the week (Figure 1) [16].


Emergency Physician Performed Ultrasound for DVT Evaluation.

Fox JC, Bertoglio KC - Thrombosis (2011)

DVT clinical algorithm suggested by the American College of Emergency Physicians (ACEP) [17].
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3211105&req=5

fig1: DVT clinical algorithm suggested by the American College of Emergency Physicians (ACEP) [17].
Mentions: CUS may be performed utilizing a whole-leg or 2-point strategy. In whole-leg CUS, both proximal and distal veins are evaluated. Two-point CUS only involves compression of the common femoral vein (CFV) and popliteal vein (PV) to their branching points. Studies have indicated that the whole-leg and 2-point strategies are equivalently effective in identifying DVT, and thrombi with potential to form PE are found in the CFV and/or PV. Therefore, emergency physicians should perform 2-point CUS and instruct patients with thrombi found distal to the popliteal vein, high pretest patients, and patients with positive D-dimer and negative CUS to consult their primary care physician and schedule a follow-up ultrasound within the week. In the event that a patient is unable to consult a physician in the necessary time frame, they should return to the ED within the week (Figure 1) [16].

Bottom Line: However, early implementation of treatment substantially improves the disease prognosis.Therefore, care must be taken to both acquire an accurate differential diagnosis for patients with symptoms as well as to screen at-risk asymptomatic individuals.However, limited availability of ultrasound technicians may result in delayed imaging or in a decision not to image low-risk cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Irvine Medical Center, University of California, 101 The City Drive South, Route 128-01, Orange, CA 92868, USA.

ABSTRACT
Deep vein thrombosis is a common condition that is often difficult to diagnose and may be lethal when allowed to progress. However, early implementation of treatment substantially improves the disease prognosis. Therefore, care must be taken to both acquire an accurate differential diagnosis for patients with symptoms as well as to screen at-risk asymptomatic individuals. Many diagnostic tools exist to evaluate deep vein thrombosis. Compression ultrasonography is currently the most effective diagnostic tool in the emergency department, shown to be highly accurate at minimal expense. However, limited availability of ultrasound technicians may result in delayed imaging or in a decision not to image low-risk cases. Many studies support emergency physiciansas capable of accurately diagnosing deep vein thrombosis using bedside ultrasound. Further integration of ultrasound into the training of emergency physicians for use in evaluating deep vein thrombosis will improve patient care and cost-effective treatment.

No MeSH data available.


Related in: MedlinePlus