Jump to comment:
- Page navigation anchor for RE: Other health care providers involved?RE: Other health care providers involved?
Hi Dr. Tallon,
Our patient was directly referred to our hospital ER by a local urgent care center. At that point in time he was recognized as having only a profoundly ischemic leg. It was our surgical and medical team who questioned VITT several days postoperatively, when he continued to clot and bleed, at the same time. VITT was never suspected by anyone at the time of his presentation, including all of his referring doctors. Sorry if we did not make that clear in the case description. We tremendously value our colleagues at the front lines of our ER, but they did not suggest that he had VITT - this was a diagnosis raised several days postoperatively.Competing Interests: None declared.References
- Melissa Jones, Annie Boisvert, Jennifer Landry, et al. Limb ischemia and pulmonary artery thrombosis afer the ChAdOx1 nCoV-19 (Oxford–AstraZeneca) vaccine: a case of vaccine-induced immune thrombotic thrombocytopenia. CMAJ 2021;10.1503/cmaj.210795.
- Page navigation anchor for RE: Important Case: Other health care providers involved?RE: Important Case: Other health care providers involved?
The case presented by the authors is timely and important. I note, however, that the patient presented to the “emergency department” (ED) and that the authors state that immediately “Upon presentation, we noted that the patient was…obese and hypoxic”.
I wonder if the emergency department physician was involved in the patient’s care or the emergency department nurses or triage personnel; I wonder if the patient was referred to the authors’ services after a workup in the ED or after being seen by a primary physician after assessment in the community? I note that there are no emergency physicians or nurses listed as co-authors.
For the hundreds of emergency departments in Canada and the thousands or physicians and nurses and other health care providers who staff those EDs, it would have been good to know what role they and the associated emergency department played in the assessment and care and recognition of this patient’s important pathology and perhaps have them as co-authors.Competing Interests: None declared.References
- Melissa Jones, Annie Boisvert, Jennifer Landry, et al. Limb ischemia and pulmonary artery thrombosis afer the ChAdOx1 nCoV-19 (Oxford–AstraZeneca) vaccine: a case of vaccine-induced immune thrombotic thrombocytopenia. CMAJ 2021;10.1503/cmaj.210795.