Ketamine for Sickle Cell Crises & VTE’s in Age-Adjusted and Pregnant patients

We are happy to report our return to in-person JC’s and I want to thank Dr. Julie Tondt, our Academic Fellow for stepping in for me this month as JC moderator. We will be looking at three articles selected by our presenters. Two of them revisit thromboembolic events and the tools available to assist us in addressing our zero-tolerance approach to missing VTE’s. Subgroups such as older and pregnant patients present unique challenges, and we have some additional data that warrants reporting. Our second topic reviews an RCT using ketamine to address pain crises in sickle cell patients.  We have seen some prior data on the use of ketamine in SC crises and it will be interesting to hear from those of you who have attempted to include the use of ketamine in your management of this patient population. We sincerely appreciate the support of EPT and the clinical insights of our community faculty and encourage you to consider joining us for what will likely be an interesting and informative discussion.

Freund Y, et al., Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism: A Randomized Clinical Trial. JAMA. 2021 Dec 7;326(21):2141-2149. Appraisal

 Bellesini M et al., D-dimer to rule out venous thromboembolism during pregnancy: A systematic review and meta-analysis. J Thromb Haemost. 2021 Oct;19(10):2454-2467. Appraisal

 Alshahrani MS et al., GUIDE Group. Ketamine administration for acute painful sickle cell crisis: A randomized controlled trial. Acad Emerg Med. 2021 Aug 27.. Epub ahead of print. PMID: 34449939. Appraisal