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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.
Diagnostics and Therapeutics: Inhalation Injuries
Dr Boggust walks us through the most important considerations for patients who present to the Emergency Department with inhalation injuries from smoke and other noxious chemicals.
Diagnostics and Therapeutics: Tumor Lysis Syndrome
Tumor lysis syndrome (TLS) is rare disease presentation in the emergency department that is very important to learn to diagnose and treat due to the high associated mortality, often quoted at 20% or more. This post discussed the pathophysiology of the disease process, as well as how to appropriate identify and treat TLS in a timely manner to prevent complications such as cardiac dysrhythmias and acute renal failure.