▶️I think, the best evidence is available for CUS with limited scope for Venography.
And no role of D-Dimer.
#FOAMed
Some thought about DVT prophylaxis in ICU.
Part of my presentation on the same topic.
Question 1: What is the incidence of DVT and PE in current era of widespread thrombo-prophylaxis?
#FOAMed
▶️I think, the best evidence is available for CUS with limited scope for Venography.
And no role of D-Dimer.
#FOAMed
#FOAMed
Yes.
1⃣Number needed to prophylax to prevent 1 DVT - 20
2⃣Number needed to prophylax to prevent 1 PE - 52
3⃣Overall no major bleeding. But bleeding risk need to be individualised.
#FOAMeYes.
1⃣LMWH decreases DVT. But no difference in Proximal DVT.
2⃣No difference in PE.
3⃣No difference in major bleeding.
4⃣Lower incidence of HIT in LMWH (PROTECT Trial).
5⃣Overall advantage LMWH.
1⃣Maximum evidence is for Dabigatran.
2⃣But unfortunately even on Dabigtran with adequate Anti-factor Xa level maintained both DVT and bleeding risk remains high.
#FOAMed
#FOAMed
Suggestions.
1⃣GCS 13-15. No bleed expansion at 48-H. Start.
2⃣GCS 13-15. Some expansion at 48-H. Start only after 72-H.
3⃣GCS 3-12. Not before 72 H. But before 7-days.
4⃣For DAI. No bleeding. Start after 72-H.
5⃣Consult Neurosurgery.
#FOAMed
1⃣Standard anticoagulation.
2⃣Limited role for Catheter Directed Thrombolysis.
More from Health
You May Also Like
This is a pretty valiant attempt to defend the "Feminist Glaciology" article, which says conventional wisdom is wrong, and this is a solid piece of scholarship. I'll beg to differ, because I think Jeffery, here, is confusing scholarship with "saying things that seem right".
The article is, at heart, deeply weird, even essentialist. Here, for example, is the claim that proposing climate engineering is a "man" thing. Also a "man" thing: attempting to get distance from a topic, approaching it in a disinterested fashion.
Also a "man" thing—physical courage. (I guess, not quite: physical courage "co-constitutes" masculinist glaciology along with nationalism and colonialism.)
There's criticism of a New York Times article that talks about glaciology adventures, which makes a similar point.
At the heart of this chunk is the claim that glaciology excludes women because of a narrative of scientific objectivity and physical adventure. This is a strong claim! It's not enough to say, hey, sure, sounds good. Is it true?
Imagine for a moment the most obscurantist, jargon-filled, po-mo article the politically correct academy might produce. Pure SJW nonsense. Got it? Chances are you're imagining something like the infamous "Feminist Glaciology" article from a few years back.https://t.co/NRaWNREBvR pic.twitter.com/qtSFBYY80S
— Jeffrey Sachs (@JeffreyASachs) October 13, 2018
The article is, at heart, deeply weird, even essentialist. Here, for example, is the claim that proposing climate engineering is a "man" thing. Also a "man" thing: attempting to get distance from a topic, approaching it in a disinterested fashion.
Also a "man" thing—physical courage. (I guess, not quite: physical courage "co-constitutes" masculinist glaciology along with nationalism and colonialism.)
There's criticism of a New York Times article that talks about glaciology adventures, which makes a similar point.
At the heart of this chunk is the claim that glaciology excludes women because of a narrative of scientific objectivity and physical adventure. This is a strong claim! It's not enough to say, hey, sure, sounds good. Is it true?
