Use caution with pregnant patients who may have VTE. Although our goal is to reduce radiation exposure to the fetus and mother, applying evidence from nonpregnant populations can be disastrous. We must be mindful to avoid unnecessary testing, but the use of CDRs and D-dimers, in particular, have little place—if any—in the risk stratification of pregnant patients.
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ACEP Now: Vol 33 – No 02 – February 2014Dr. Klauer is director of the Center for Emergency Medical Education (CEME) and chief medical officer for Emergency Medicine Physicians, Ltd., Canton, Ohio; on the Board of Directors for Physicians Specialty Limited Risk Retention Group; assistant clinical professor at Michigan State University College of Osteopathic Medicine; and medical editor-in-chief of ACEP Now.
References
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- Henriksson P, Westerlund E, Wallén H, et al. Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: cross sectional study. BMJ. 2013;346:e8632.
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- Kline JA, Mitchell AM, Kabrhel C, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2:1247-1255.
- Kline JA, Slattery D, O’Neil BJ, et al. Clinical features of patients with pulmonary embolism and a negative PERC rule result. Ann Emerg Med. 2013;61:122-124.
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