Indications and Contraindications for ERCP in Patients with Acute Biliary Pancreatitis

Recent guidelines published by the American College of Gastroenterology suggest that urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 hours after admission) is indicated in patients with biliary pancreatitis who have concurrent acute cholangitis, but it is not needed in most patients who do not have evidence of ongoing biliary obstruction.
Continue reading

Indications and Contraindications Radioiodine Treatment of Differentiated Thyroid Cancer (DTC)

Differentiated thyroid cancer (DTC) is defined as a carcinoma deriving from the follicular epithelium and retaining basic biological characteristics of healthy thyroid tissue, including expression of the sodium iodide symporter (NIS), the key cellular feature for specific iodine uptake.
Continue reading

Clinical Indications and Contraindications to Percutaneous Coronary Intervention (PCI)

Percutaneous coronary interventions (PCI) include percutaneous transluminal coronary angioplasty (PTCA) with or without stenting. Primary indications are treatment of angina pectoris (stable or unstable), myocardial ischemia, and acute MI (particularly in patients with developing or established cardiogenic shock).
Continue reading

Indications and Contraindications for Targeted Temperature Management in Comatose Patients after Cardiac Arrest

Targeted temperature management should be implemented in the context of a broader strategy of critical care for a comatose patient with the post-cardiac arrest syndrome.

Continue reading

Indications and Contraindications for Tube Thoracostomy

Indications for chest drain insertion

  • Pneumothorax
    • in any ventilated patient
    • tension pneumothorax after initial needle relief
    • persistent or recurrent pneumothorax after simple aspiration
    • large secondary spontaneous pneumothorax in patients over 50 years Continue reading

Indications and Contraindications for Abdominal Paracentesis

Removal of abdominal fluid is of value in evaluating patients with ascites of new onset or unknown etiology, and provides symptomatic relief in patients with known disease or in the setting of a decompensating clinical state. Abdominal paracentesis is a simple procedure that may be performed rapidly and with a minimum of equipment.

Continue reading

Indications and Contraindications for Tilt Table Testing

Indications

  • Recurrent syncope or single syncopal episode accompanied by physical injury or motor vehicle crash or occurring in a high risk setting (for example, pilot, surgeon, commercial vehicle driver) and no evidence of structural cardiovascular disease; or presence of structural cardiovascular disease but other causes of syncope ruled out by diagnostic testing

  • Syncope induced by or associated with exercise

  • Further evaluation of patients in whom an apparent specific cause of syncope has been established (for example, asystole, high atrioventricular block) but susceptibility to neurocardiogenic syncope may affect treatment plan

    Continue reading