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Can a Nitro Slurry Fix a Food Bolus Impaction?
Esophageal food impaction (EFI) occurs at an estimated rate of 13 episodes per 100,000 people annually. Medical management is typically attempted before resorting to endoscopy to reduce procedural risks and resource use. Glucagon remains the most widely used medication. Other treatments include carbonated beverages, benzodiazepines, and, more recently, nitroglycerin. Despite glucagon being the most commonly used agent, its supporting data are limited to small studies or case reports. One older study showing over 60% efficacy lacked a comparator group and had multiple confounders. Another study suggested only minimal benefit and significant adverse effects—up to 50% vomiting—highlighting the need for better treatment options.
Grand Rounds Recap 12.11.24
Another week, another great Grand Rounds! First, Dr. Lang takes us through the evidence behind our common treatment of low back pain. Next, Drs. Boyer and Segev give us a evidence guided management of the acutely ischemic limb. Next, Dr. Hajdu takes us through a difficult case of cardiac arrest in the ED. Finally, we learn all about infections of the pelvis and perineum with Dr. Guay!
Serotonin Syndrome & NMS
It can be a challenge to differentiate NMS and Serotonin syndrome, careful attention to historical factors, a thorough medication history, and a detailed physical exam and neurologic exam is necessary to quickly diagnose these patients. This post details the presentation of each entity and highlights the differences between the two.