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Blood and Clots Series: Diagnosing pulmonary embolism in pregnancy

In Blood & Clots, Medical Concepts by Eric Tseng1 Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Case Description  A pregnant 32 year old female presents to the ER with chest pain. She is 33 weeks gestational age, and this is her third pregnancy (two prior uneventful deliveries). Her pain started 3 hours ago while she was watching television. It is sharp, worse with inspiration, and located along the right costal margin. …

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Blood and Clots Series: What are the complications of transfusion? What symptoms/signs should I worry about?

In Blood & Clots, Medical Concepts by Matthew NicholsonLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert, Communicator, Leader Case Description You are a resident physician rotating through the ICU. You’ve been taking care of a 32-year-old woman who sustained injuries in a high-speed motor vehicle collision two days ago. She is now stable and extubated in the ICU. Her hemoglobin has been stable in the 80s since arriving in the ICU …

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Blood and Clots Series: Massive transfusion protocol: what is it, why does it exist, and when should I call one?

In Blood & Clots, Medical Concepts by Matthew NicholsonLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Case Description  A 32-year old woman presents to the ED following a motor vehicle collision with lateral impact (T-bone collision) and is brought into the trauma bay. Significant bleeding was reported on scene and the patient arrives looking diaphoretic, pale, and unwell. Vitals in the trauma bay are BP 104/64 mmHg, HR 128, RR 22 …

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Blood and Clots Series: Does my complex patient have DIC?

In Blood & Clots, Medical Concepts by Andrew ShihLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert Case Description You are seeing a 56M in your critical care suite who has just arrived as a transfer from a peripheral hospital.  The patient has had a recent diagnosis of acute leukemia and was given chemotherapy and a recent stem cell transplant 20 days ago at this hospital.  When he started getting sicker, they requested …

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Blood and Clots Series: When can patients on direct anticoagulants have surgery?

In Blood & Clots, Medical Concepts by Kerstin de WitLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Professional, Collaborator, Medical expert As a Thrombosis specialist, I am often paged by emergency physicians and orthopedic surgeons requesting anticoagulation reversal in order to facilitate surgery. There are some simple and important points to remember when dealing with this clinical scenario. Case Description It is 8am on Monday morning and you are the orthopedic resident on call …

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Blood and Clots Series: My patient has a pulmonary embolism. Should I screen them for cancer?

In Blood & Clots, Medical Concepts by Eric TsengLeave a Comment

All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Expert, Leader Case Description An 83 year old female presents for follow-up after completing 3 months of oral anticoagulant therapy with Rivaroxaban for her unprovoked deep vein thrombosis. She did some research online and heard about a link between venous thrombosis and cancer, and asks why you are not getting a CT scan to rule out malignancy. …