17 04, 2017

AIR-Pro: Gastroenterology

Welcome to the Gastroenterology AIR-Pro Module. Below we have listed our selection of the 10 highest quality blog posts related to 4 advanced level questions on toxicology topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions:

  1. Cirrhosis and variceal bleeding
  2. Food impaction
  3. Management of diverticulitis
  4. Airway management in the gastrointestinal bleed

In this module, we have 8 AIR-Pro’s and 2 Honorable Mentions. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net and FOAMSearcher.

(more…)

10 04, 2017

The Post-ROSC Checklist

2017-04-05T14:10:47+00:00

In emergency medicine, we are so heavily trained in resuscitation that any senior resident could recite the ACLS algorithm to you after being woken up at 3 am. However, the real work begins after the pulse return. Up to two-thirds of patients with return of spontaneous circulation (ROSC) will not survive to discharge.1,2 This approach, modeled after the 2015 American Heart Association Guidelines3 and an excellent review article by Dr. Jacob Jentzer et al,4 can help guide you through the chaos to stabilize your next post-ROSC patient.

(more…)

22 03, 2017

Trick of the Trade: Sphenopalatine Ganglion Block for Treatment of Primary Headaches

2017-03-25T04:09:50+00:00

It is thought that the autonomic nervous system is likely involved in migraines and other primary headache disorders given commonly associated symptoms such as nausea, lacrimation, emesis, and rhinorrhea. The sphenopalatine ganglion (SPG) is an extracranial parasympathetic ganglion with both sensory and autonomic fibers. It has therefore been hypothesized that blockade of the sphenopalatine ganglion may produce relief from primary headaches by modulating the autonomic fibers involved in headache disorders.1

While in our anecdotal experience with SPG blocks has been overall very positive, thus far there have been only a few small studies that have investigated it’s use in the Emergency Department. The currently available evidence has been mixed.

(more…)

16 03, 2017

PEM Pearls: 2017 AAP Section of EM’s Guide to Pediatric Community Acquired Pneumonia

2017-03-13T13:53:49+00:00

Pediatric community acquired pneumonia left side - image courtesy of Dr. Rob CooneyPediatric community-acquired pneumonia (CAP) is an acute, common, and potentially serious infection of the pulmonary parenchyma in children. In November 2010, the American Academy of Pediatrics endorsed “The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.” [PDF]1Based on this guideline, the American Academy of Pediatrics (AAP) Section on Emergency Medicine’s Committee on Quality Transformation developed a clinical algorithm for CAP in the ED setting.

(more…)

15 03, 2017

Beyond the Abstract: Patient video testimonials improve physician interpretation of advance directives and POLST

2017-03-10T13:21:48+00:00

advance directives and POLST with videoOver 1,300 physicians across the U.S. were asked to interpret patient preferences for end-of-life care in theoretical cases. Physicians rarely reached consensus about patient preferences when they were given only living wills and POLST documents to interpret. The addition of a patient video testimonial helped physicians make better care decisions that reflected their patients’ wishes. Will video become the new national standard for advance care planning?

(more…)