DVT complete diagnostic approach resident survival guide: Difference between revisions
Jump to navigation
Jump to search
Rim Halaby (talk | contribs) No edit summary |
Rim Halaby (talk | contribs) No edit summary |
||
| Line 2: | Line 2: | ||
{{familytree | | | | | | | A01 | | | | | | | | | | | | | | | | | A02 | A01= Suspected high-risk PE| A02= Suspected non-high risk PE}} | {{familytree | | | | | | | A01 | | | | | | | | | | | | | | | | | A02 | A01= Suspected high-risk PE| A02= Suspected non-high risk PE}} | ||
{{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }} | {{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }} | ||
{{familytree | | | | | | | A03 | | | | | | | | | | | | | | | | | |!| A03= Administer anticoagulation (in case there are no contraindications) during the diagnostic workup}} | {{familytree | | | | | | | A03 | | | | | | | | | | | | | | | | | |!| A03= Administer anticoagulation <br>(in case there are no contraindications)<br>during the diagnostic workup}} | ||
{{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }} | {{familytree | | | | | | | |!| | | | | | | | | | | | | | | | | | |!| }} | ||
{{familytree | | | | | | | B01 | | | | | | | | | | | | | | | | | B02| B01= Is a CT available immediately?| B02= What is the pretest probability of PE?}} | {{familytree | | | | | | | B01 | | | | | | | | | | | | | | | | | B02| B01= Is a CT available immediately?| B02= What is the pretest probability of PE?}} | ||
| Line 12: | Line 12: | ||
{{familytree | | | E01 | | | | | | | | | | |!| | | | | E02 | | E03 | | E04 | E01= Does the patient have RV overload?| E02= Low pretest probability |E03= Intermediate pretest probability| E04= High pretest probability <br>OR<br> PE is likely}} | {{familytree | | | E01 | | | | | | | | | | |!| | | | | E02 | | E03 | | E04 | E01= Does the patient have RV overload?| E02= Low pretest probability |E03= Intermediate pretest probability| E04= High pretest probability <br>OR<br> PE is likely}} | ||
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | |!| |!| | | | |!| }} | {{familytree | | | |!| | | | | | | | | | | |!| | | | | | |!| |!| | | | |!| }} | ||
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | |!| | N01 | | |!| N01= Administer anticoagulation (in case there are no contraindications) during the diagnostic workup}} | {{familytree | | | |!| | | | | | | | | | | |!| | | | | | |!| | N01 | | |!| N01= Administer anticoagulation <br>(in case there are no contraindications)<br>during the diagnostic workup}} | ||
{{familytree | |,|-|^|-|-|-|.| | | | | | | |!| | | | | | |!| |!| | | | |!| | }} | {{familytree | |,|-|^|-|-|-|.| | | | | | | |!| | | | | | |!| |!| | | | |!| | }} | ||
{{familytree | F01 | | | | F02 | | | | | | F03 | | | | | | F04 | | | | |!| F01= No| F02= Yes| F03= Order CT| F04= Order D-dimer}} | {{familytree | F01 | | | | F02 | | | | | | F03 | | | | | | F04 | | | | |!| F01= No| F02= Yes| F03= Order CT| F04= Order D-dimer}} | ||
Revision as of 16:13, 15 May 2014
| Suspected high-risk PE | Suspected non-high risk PE | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Administer anticoagulation (in case there are no contraindications) during the diagnostic workup | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Is a CT available immediately? | What is the pretest probability of PE? | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Yes | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Order echocardiography | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Does the patient have RV overload? | Low pretest probability | Intermediate pretest probability | High pretest probability OR PE is likely | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Administer anticoagulation (in case there are no contraindications) during the diagnostic workup | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Yes | Order CT | Order D-dimer | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive | Negative | Negative | Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Is the patient unstable OR no other tests are available? | Is the patient stabilized AND CT is now available? | PE is excluded | Order CT | Order CT | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Negative | Positive | Negative | Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| PE is excluded | Consider thrombolysis or embolectomy | Order CT | PE is confirmed | PE is excluded | PE is excluded | PE is confirmed | PE is excluded | PE is confirmed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive for PE | Negative for PE | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| PE is confirmed | PE is excluded | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||