Could adjusting D-dimer thresholds to clinical probability reduce ultrasound use for suspected DVT? This 2022 appraisal of the Canadian 4D study examines diagnostic safety, excluded patient groups and the challenges of transferring its algorithm into UK pathways.
Suspected DVT: the 4D study Read More
An August 2021 appraisal of therapeutic-dose heparin in hospitalised COVID-19 patients without ICU-level organ support. It examines the multiplatform trial’s benefits, bleeding-risk exclusions and composite outcome, and explains why these findings differ from those in critically ill patients.
JC: Thromboprophylaxis for the non ICU hospitalised COVID-19 patient. St Emlyn’s Read More
A March 2021 appraisal of anticoagulation trials in critically ill patients with COVID-19. Simon Carley and Dan Horner examine therapeutic-dose versus usual-care thromboprophylaxis, organ support outcomes and bleeding, explaining why the findings cannot simply be extended to ward patients or treatment of confirmed thrombosis.
JC: Thromboprophylaxis on the ICU for COVID-19 patients. St Emlyn’s Read More
Dan Horner revisits the evidence on venous thromboembolism in COVID-19 as it stood in October 2020. The review examines how screening and case selection affect reported clot rates, the distinction between different thrombotic findings, and uncertainty around risk prediction and higher-dose anticoagulation.
VTE and COVID-19: Would you like to know more? Read More
Iain and Simon review May 2020 on St Emlyn’s, including COVID-19 research discussions and venous thromboembolism resources. The written episode notes also connect global health, race and inequality with reflections on privilege and the perspectives emergency clinicians bring to their work.
Podcast – May 2020 Monthly Round Up Read More
Dan Horner examines the difficulties of diagnosing and treating venous thromboembolism in COVID-19 in May 2020. The review considers D-dimer, imaging, screening effects and possible immunothrombosis, weighing uncertain treatment benefits against bleeding risks while randomised trial results were still awaited.
Diagnosis and Treatment of VTE in the COVID-19 era Read More
Dan Horner reviews the 2020 NICE guidance on diagnosing and managing venous thromboembolism. The article discusses PERC, age-adjusted D-dimer, outpatient pulmonary embolism care and anticoagulant choices, including cancer-associated VTE, with attention to patient selection, bleeding risk and questions outside the guideline’s scope.
New NICE Guidelines on diagnosis and management of venous thromboembolism Read More
How should we assess and reduce venous thromboembolism risk after lower-limb immobilisation? Dan Horner reviews the 2019 TiLLI project, examining thromboprophylaxis evidence, risk assessment tools and cost-effectiveness, while highlighting uncertainty about which patients benefit and how to communicate that risk.
Thromboprophylaxis in Lower Limb Immobilisation #RCEMASC2019 Read More
