D-Dimer for Dissection and Evidence Update with Dr. Lauren Westafer

Emergency medicine practice is evolving through updated guidelines on diagnostic testing and therapeutic interventions. Dr. Lauren Westafer highlights the use of the ADD risk score combined with D-Dimer to safely rule out thoracic aortic dissection. Recent evidence indicates that COVID-19 antivirals offer minimal benefit for vaccinated, non-high-risk patients, while early basal insulin administration improves DKA resolution. Regarding pulmonary embolism, clinical guidelines now emphasize low-molecular-weight heparin over unfractionated heparin and advocate for echocardiography over CT for assessing right ventricular strain. Furthermore, the discussion challenges the efficacy of catheter-directed thrombolysis, noting that patient-oriented benefits remain unproven in recent trials. Finally, IV sodium bicarbonate emerges as a potential alternative to traditional antihistamines for managing acute peripheral vertigo, offering a treatment option that avoids the sedative side effects associated with standard vestibular suppressants.