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filter). In this particular circumstance, if patient symptoms have been recognized as a PE, fibrinolytic therapy may have rapidly reversed right-sided heart failure, preventing the patient’s death (Buttaro, 2017).ReferencesButtaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.Fleming, F., Gaether, W., Ternent, C., Finlayson, E., Herzig, D., Paquette, I., … Steele, S. (2018). The American Society of Colon and Rectal Surgeons clinical practice guideline for the prevention of venous thromboembolic disease in colorectal surgery. Disease of the Colon & Rectum. doi: 10.1097/DCR.0000000000000982Lee, J., Grochow, D., Drake, D., Johnson, L., Reed, P., van Servellen, G. (2014). Evaluation of hospital nurses’ perceived knowledge and practices of venous thromboembolism assessment and prevention. Journal of Vascular Nursing, 32(1), p.18-25. Retrieved from Moghadamyeghaneh, Z., Hanna, M., Carmichael, J., Nguyen, N., & Stamos, M. (2014). A nationwide analysis of postoperative deep vein thrombosis and pulmonary
embolism in colon and rectal surgery. Journal of Gastrointestinal Surgery, 18, p. 2109-2177. doi: 10.1007/s11605-014-2647-5.Siegl, R.L., Miller, K.D., & Jemel, A. (2017). Cancer statistics. Cancer Journal for Clinicians, 67(1), p. 7-30. doi: 10.3322/caac.21387Tan, S. & Haramati, L. (2016). Overdiagnosis versus misdiagnosis of pulmonary embolism. American Journal of Roentgenology, 206(4), p. 59. doi: 10.2214/AJR.15.15769Tapsen, V. (2015). Pulmonary embolism (PE). Merck Manual Professional Version. Retrieved from -disorders/pulmonary-embolism-pe/pulmonary-embolism-peResponse Post 1Gretchen, Thank you for your post and information on case study #2. I absolutely agree thatthe well being of the patient should always be a priority.In any patient presenting with leg pain, the potential for DVT should be suspected, and as clinical diagnosis can be neither specific nor sensitive, classic symptoms that include tenderness at the site, pain, redness, swelling, and calf pain on dorsiflexion (Homan’s sign), however, some individuals are asymptomatic, but a unilateral increase in calf diameter is a very useful finding. As lower extremity DVT’s are more likely to cause a pulmonary embolism, diagnosis of lower extremity DVT’s are vitally important (Douketis, 2016).
One diagnostic application that is well used for initial screening of DVT’s is an ultrasound. The pocket-sized ultrasound examination (PUE) device has a feasibility for visualization with 94% of the iliac vein, 98% of the femoral vein, 100% for the popliteal vein, and 96% for the peroneal, tibial, and soleal veins, with an average examination timeof 7.4 3 minutes, with sensitivity and specificity of 100%, and detectability of a DVT used by the PUE was approximately 7.1mm (Nakanishi et al., 2016).As a nurse practitioner in a primary care setting, would you consider the use of a pocket-sized ultrasound to prevent patients from having to use the emergency room?