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Phlegmasia Cerulean Dolens

CASE A 35 yo woman presents with a painful blue swollen leg, that occurred rapidly, the evening before. There is little relevant past history and the patient is on the oral contraceptive pill. Examination reveals a dusky, blue left leg, that is swollen in comparison to the other side. Pulses are present and the patient in neurologically…

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Do you rule out DVT with a D-Dimer?

Deep Venous Thrombosis(DVT) occurs in approximately 1-2 per 1000 of the population. Our great concern is not the DVT as such, but the potential for other sequelae, especially a pulmonary embolism. What I see and what I’m also guilty of, on several occasions is that these patients are simply sent to ultrasound and we don’t…

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Why I love vascular ultrasound!

I remember a time before the ultrasound when all the central lines I would do (except for coagulopathic patients) were subclavian lines. I had a real concern about the rate of pneumothoraces using the internal jugular approach. Now, they are all I will do. Thanks to the ultrasound. You don’t have to be an ultrasound…

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Carotid Dissection-When to Suspect, When to Scan.

Have you ever wanted to order a test, especially a radiological one and after hours at that and were made to feel inept, for asking? It’s after 11pm, here’s the how the conversation goes: PK: “Hello Dr (fill in space) PK here, one of the ED consultants. Sorry to bother you, but I wanted to…

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