emDOCs.net Emergency Medicine (EM) Podcast
Episode 101: Acute Chest Syndrome Part 2
May 28, 2024
Dr. Brit Long discusses challenges in oximetry assessment, progression of acute chest syndrome, and links to pulmonary embolism. Also covers risk factors for PE, complications of pulmonary hypertension, and optimal care strategies for sickle cell disease patients in the ED.
13:49
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Quick takeaways
- Inaccuracies in pulse oximetry readings for acute chest syndrome can mislead by underestimating pulmonary infarction and overestimating oxygen saturation.
- Risk factors for acute chest syndrome in sickle cell disease patients include fever, low oxygen saturation, history of asthma, lower baseline hemoglobin, and leukocytosis, with severe manifestations more common in adults.
Deep dives
Evaluation of Pulse Oximetry Readings
Pulse oximetry readings in patients with acute chest syndrome may be unreliable due to potential inaccuracies. Data suggests that pulse oximetry can underestimate pulmonary infarction and overestimate arterial blood oxygen saturation. Factors like hypothermia, hypotension, and basal constriction can influence readings. In cases of inconsistency between clinical status and pulse oximetry, consider obtaining an ABG or using co-oximetry.
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