Between 350,000 and 600,000 Americans each year contract Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE), and at least 100,000 deaths are thought to be related to these diseases each year. There is great hope and optimism about prevention, diagnosis and treatment of these diseases. We have made progress in our knowledge of how to prevent, diagnose and treat DVT/PE. But, we are not applying that knowledge on a systematic basis. This Call to Action is intended to serve as a stimulus for the development of a coordinated plan to reverse the current trend and dramatically reduce the morbidity and mortality caused by DVT/PE. It outlines the kinds of activities that are part of this plan. Illustrations.
Over the last several decades we have seen dramatic drops in the mortality rates from cardiovascular disease, the leading cause of death in this country. Yet challenges remain, and certain areas of medicine have not seen improvements. One of the biggest challenges relates to blood clots in the legs (a disease known as deep vein thrombosis or DVT), which can not only cause pain, swelling, and other discomfort, but also frequently travel to the lungs, causing a potentially fatal pulmonary embolism (PE). The best estimates indicate that 350,000 to 600,000 Americans each year suffer from DVT and PE, and that at least 100,000 deaths may be directly or indirectly related to these diseases. This is far too many, since many of these deaths can be avoided. Because the disease disproportionately affects older Americans, we can expect more suffering and more deaths in the future as our population ages–unless we do something about it. The Institute of Medicine has classified the failure to provide appropriate screening and preventive treatment to hospitalized, at-risk patients as a medical error, and the Agency for Healthcare Research and Quality has ranked the provision of such preventive treatment as one of the most important things that can be done to improve patient safety. Proven, effective measures are available to prevent and treat DVT and PE in high-risk individuals. Yet today the majority of individuals who could benefit from such proven services do not receive them. Too few Americans know what DVT or PE is, how to recognize the symptoms, or how to talk with their clinicians about prevention, diagnosis, and treatment. Too few health care professionals are aware of the evidence-based practices for identifying high-risk patients and providing preventive, diagnostic, or therapeutic services. Additionally, as in any area of medicine, gaps still remain in our knowledge about how best to care for certain patient subpopulations, and further research is needed. This Surgeon General's Call to Action represents an opportunity for multiple stakeholders to come together in a coordinated effort to reverse the projected trends and to dramatically reduce the pain and suffering caused by DVT and PE in this nation through specific steps in communication, action, research and evaluation. With the involvement of individuals, families, communities, all aspects of research and health care systems, organizations, governments, and the media, we can bring better health to this country.
This first "Call to Action to Prevent Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)," provides vital information on critical health problems that cause enormous health consequences and numerous deaths in our country.
Dedicated to dealing with a challenging disease, previously thought to be incurable, but with the advent of new drugs, now amenable to management and a much improved prognosis for patients. - Latest publication in a fast-moving area of keen clinical interest - Authored by leading international authorities - Builds on success of a respected first edition - Incorporates new data on latest imaging technologies and therapies - Covers both the science and clinical aspects, including presentation, surgical intervention and drug therapy - Includes coverage of both Pulmonary Embolism and Deep Vein Thrombosis
Venous thromboembolism (VTE) occurs less often in children than adults and therefore remains underrecognized despite increasing in incidence. Due to the risk of mortality, short- and long-term morbidity, and increased healthcare costs associated with pediatric VTE, this entity merits better understanding and consideration. With this Research Topic, we aim to highlight some special considerations of pediatric VTE, namely risk factors and epidemiology, rare types of pediatric thrombosis and considerations unique to specific clinical patient subgroups, approaches to management and treatment, and prevention.
Fully updated to reflect current evidence based practice Deep Vein Thrombosis and Pulmonary Embolism: A guide for Practitioners covers the pathology and common problems in clinical medicine and general practice related to venous thrombosis. The new edition has details of the theory and practice of traditional drugs and the use of non-Vitamin K antagonist oral anticoagulants (NOACs) and overall the book will enable the practitioner to manage their patients with confidence Contents include: Introduction What is deep vein thrombosis and pulmonary embolism and why are they important? Who is at risk of these conditions and why? Recognising and confirming DVT and PE What have we got to treat these conditions? Clinical practice of anticoagulation Heparin and LMWH Warfarin Non-vitamin K antagonist anticoagulants (NOACs) What happens if something goes wrong? – Haemorrhage References Answers to Consolidation notes and Case Studies
The heart and lung are intricately linked. When the heart is affected by disease, the lungs will often show some related pathological or clinical conditions and vice versa. Pulmonary heart disease is by definition a condition when the lungs cause the heart to fail. The left ventricle in combination with the other structures in the “left heart” pumps blood throughout the body. The right ventricle (and structures of the “right heart”) pumps blood to the lungs where it is oxygenated and returned to the left heart for distribution. In normal circumstances, the right heart pumps blood into the lungs without any resistance. The lungs usually have minimal pressure and the right heart easily pumps blood through. However when there is lung disease present, like emphysema, chronic obstructive lung disease (COPD) or pulmonary hypertension- the small blood vessels become very stiff and rigid. The right ventricle is no longer able to push blood into the lungs and eventually fails. This is known as pulmonary heart disease. Pulmonary heart disease is also known as right heart failure or cor pulmonale. The chief cause of right heart failure is the increase in blood pressure in the lungs (pulmonary artery).
The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism.- New developments in the thrombolytic therapy of venous thrombosis.- Mechanism of blood coagulation. Newer aspects of anticoagulant and antithrombotic therapy.MR-angiography in the diagnosis of pulmonary embolism.Scintigraphy-ventilation/perfusion scanning and imaging of the embolus.- Clinical course and prognosis of acute pulmonary embolism.- The molecular mechanisms of inherited thombophilia.
This pocket book succinctly describes 318 errors commonly made by attendings, residents, interns, nurses, and nurse-anesthetists in the intensive care unit, and gives practical, easy-to-remember tips for avoiding these errors. The book can easily be read immediately before the start of a rotation or used for quick reference on call. Each error is described in a short, clinically relevant vignette, followed by a list of things that should always or never be done in that context and tips on how to avoid or ameliorate problems. Coverage includes all areas of ICU practice except the pediatric intensive care unit.
The first edition of this publication was aimed at defining the current concepts of trauma induced coagulopathy by critically analyzing the most up-to-date studies from a clinical and basic science perspective. It served as a reference source for any clinician interested in reviewing the pathophysiology, diagnosis, and management of the coagulopathic trauma patient, and the data that supports it. By meticulously describing the methodology of most traditional as well as state of the art coagulation assays the reader is provided with a full understanding of the tests that are used to study trauma induced coagulopathy. With the growing interest in understanding and managing coagulation in trauma, this second edition has been expanded to 46 chapters from its original 35 to incorporate the massive global efforts in understanding, diagnosing, and treating trauma induced coagulopathy. The evolving use of blood products as well as recently introduced hemostatic medications is reviewed in detail. The text provides therapeutic strategies to treat specific coagulation abnormalities following severe injury, which goes beyond the first edition that largely was based on describing the mechanisms causing coagulation abnormalities. Trauma Induced Coagulopathy 2nd Edition is a valuable reference to clinicians that are faced with specific clinical challenges when managing coagulopathy.
