St. Paul's Hospital Emergency Department The Continuous Pursuit of Excellence in Patient Care and Academic Emergency Medicine

CT Pulmonary Angiography from Department of Emergency Medicine on Vimeo.

Dr J Leipsic discusses recent advances in Pulmonary Angiography and its utility in the ED and beyond.

Contrast Induced Nephropathy from Department of Emergency Medicine on Vimeo.

Dr T Gleeson (Radiology) discusses recent evidence regarding Contrast Induced Nephropathy, how to prevent it and how to treat it should it happen.

This article concludes that:

"Hydration with sodium bicarbonate before contrast exposure is more effective than hydration with sodium chloride for prophylaxis of contrast-induced renal failure. "

JAMA. 2004;291:2328-2334.  (Link)

 

A Meta-analysis of outcomes in patients with suspected PE managed based on CT pulmonary angiography compared to those managed based on conventional pulmonary angiography.  They conclude that the safety and subsequent venous thromboembolic disease is similar in both groups.

Ann Intern Med. 2004;141:866-874. (Link)

A California study that found that a detailed clinical exam had no diagnostic value in detecting intra-cranial injuries found on CT scan.  They make the following recommendation: Patients with observed loss of consciousness or amnesia and Glasgow Coma Scale 13–15 should have a head computed tomography scan as part of their evaluation to avoid missing an intracranial injury. Pediatr Crit Care Med 2004; 5:230 –233. (Link)