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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
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A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
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Related Experiment Video

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Training in interventional pulmonology.

David Feller-Kopman1, Lonny Yarmus1

  • 1Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, Johns Hopkins Hospital, Baltimore, Maryland.

Seminars in Respiratory and Critical Care Medicine
|December 3, 2014
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Summary

Interventional pulmonology (IP) is a growing medical subspecialty. Dedicated IP fellowships, established in the early 2000s, train physicians in advanced diagnostic and therapeutic procedures for lung diseases.

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Area of Science:

  • Pulmonary Medicine
  • Interventional Pulmonology

Background:

  • Interventional pulmonology (IP) is a rapidly growing subspecialty of pulmonary and critical care medicine (PCCM).
  • It focuses on evaluating and managing patients with lung nodules, masses, mediastinal and hilar adenopathy, central airway obstruction, and pleural disease.

Purpose of the Study:

  • To review the evolution of interventional pulmonology.
  • To outline the pathways for learning advanced procedural techniques in IP.

Main Methods:

  • Review of the historical development of IP training.
  • Analysis of current IP fellowship structures and curricula.

Main Results:

  • Dedicated IP fellowships emerged in the early 2000s.
  • There are approximately 24 IP fellowships in the United States.
  • These fellowships provide training beyond standard PCCM fellowship scope.

Conclusions:

  • IP has evolved from an apprenticeship model to a formal fellowship structure.
  • Formal training pathways are crucial for acquiring advanced diagnostic and therapeutic skills in IP.