scholarly journals Emergency Physician Performed Ultrasound for DVT Evaluation

Thrombosis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
John Christian Fox ◽  
Kiah Christine Bertoglio
Keyword(s):  
Deep Vein Thrombosis ◽  
Improve Patient Care ◽  
Cost Effective ◽  
Diagnostic Tools ◽  
Delayed Imaging ◽  
Vein Thrombosis ◽  
Early Implementation ◽  
Cost Effective Treatment ◽  
Asymptomatic Individuals ◽  
Deep Vein

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.

Diagnosis Of Deep Vein Thrombosis - “The Case for NonInvasive Testing”

1981 ◽  
Author(s):  
R Hull ◽  
J Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
High Sensitivity ◽  
Cost Effective ◽  
Impedance Plethysmography ◽  
Noninvasive Testing ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Long Term Follow Up ◽  
Deep Vein ◽  
High Degree

Ascending venography, although the diagnostic standard for deep vein thrombosis (DVT), has important clinical pitfalls and shortcomings. It is invasive and thus not readily repeated: its use is associated with significant discomfort in many patients and in 3-4% of patients post-veno- graphic phlebitis is induced. A high degree of technical and interpretive skill is required and in up to 20% of patients routine ascending venography fails to visualize the external and common iliac veins. In many hospitals, outpatient access is not readily available necessitating admission to hospital for elective venography. Non-invasive testing with impedance plethysmography (IPG) is gaining increasing acceptance and use because it is objective, versatile and free of morbidity. IPG is sensitive and specific for symptomatic proximal DVT, but has the potential limitation that it is insensitive to calf DVT. Because of this, two different non-invasive approaches are currently advocated: a) serial IPG’s to detect calf vein thrombi which extend proximally (advocates of this approach suggest that calf DVT rarely lead to symptomatic pulmonary emboli unless proximal extension occurs) and b) addition of leg scanning to detect calf DVT. The effectiveness of serial IPG’s is uncertain and to resolve this issue we are currently performing a randomized trial. Multiple large studies however demonstrate that because of both high sensitivity and specificity, the combined approach of IPG and leg scanning provides a replacement for venography in the majority of symptomatic patients. Furthermore, the safety of witholding anticoagulant therapy in patients negative by combined IPG and leg scanning has been confirmed by long-term follow-up. Combined IPG and leg scanning is more cost-effective than elective venography because these non-invasive tests are readily performed in the emergency room or clinic, thus preventing unnecessary admission to hospital of patients with clinically suspected DVT who are negative by testing.

scholarly journals Outpatient total knee arthroplasty: is it worth considering?

2020 ◽  
Vol 5 (3) ◽  
pp. 172-179
Author(s):  
E. Carlos Rodríguez-Merchán
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Discharge Planning ◽  
Young Patients ◽  
Cost Effective ◽  
Medical Outcomes ◽  
Vein Thrombosis ◽  
Cost Effective Treatment ◽  
Total Knee ◽  
Deep Vein

Some authors have reported that outpatient total knee arthroplasty (TKA) is a successful, safe and cost-effective treatment in the management of advanced osteoarthritis. The success obtained has been attributed to the coordination of the multidisciplinary team, standardized perioperative protocols, optimal hospital discharge planning and careful selection of patients. One study has demonstrated a higher risk of perioperative surgical and medical outcomes in outpatient TKA than inpatient TKA, including component failure, surgical site infection, knee stiffness and deep vein thrombosis. There remains a lack of universal criteria for patient selection. Outpatient TKA has thus far been performed in relatively young patients with few comorbidities. It is not yet clear whether outpatient TKA is worth considering, except in very exceptional cases (young patients without associated comorbidities). Outpatient TKA should not be generally recommended at the present time. Cite this article: EFORT Open Rev 2020;5:172-179. DOI: 10.1302/2058-5241.5.180101

scholarly journals Deep Vein Thrombosis – Current Management Strategies

2016 ◽  
Vol 8 ◽  
pp. CMT.S18890 ◽  
Author(s):  
Heike Endig ◽  
Franziska Michalski ◽  
Jan Beyer-Westendorf
Keyword(s):  
Deep Vein Thrombosis ◽  
Management Strategies ◽  
Cost Effective ◽  
Drug Dosage ◽  
Late Complications ◽  
Specific Situation ◽  
Vein Thrombosis ◽  
Clinical Scenarios ◽  
The Individual ◽  
Deep Vein

Deep vein thrombosis (DVT) is a frequent and potentially life-threatening condition, and acute and late complications are common. The diagnostic approach to DVT needs to be reliable, widely available, and cost-effective. Furthermore, several therapeutic options are available for DVT treatment and the choice of anticoagulant drug, dosage, and treatment duration has to reflect the specific situation of the individual DVT patient. This review was aimed to provide bedside guidance for clinicians faced with common (and less common) clinical scenarios in DVT treatment.

Sign in / Sign up

Export Citation Format

Share Document