Podcast #243: Sphenopalatine Nerve Block

Podcast #243: Sphenopalatine Nerve Block

Author: Don Stader, M.D.

Educational Pearls

  • Cluster headaches are usually intense, unilateral, and involve the periorbital area.
  • CN V (Trigeminal) provides sensory and autonomic innervation the face and eyes, which play roles in headache pathology.
  • Cluster headaches can be treated with high flow oxygen, but a new treatment involves blocking the sphenopalatine ganglion (SPG) with lidocaine. Because sensory and autonomic branches of the trigeminal traverse the SPG, lidocaine will effectively treat a cluster headache.
  • To block the ganglion, intranasal lidocaine may be used, or a Q-tip soaked in 4% lidocaine can be applied to the most posterior aspect of the pharynx for 10-15 minutes.

References: https://www.aliem.com/2017/03/trick-sphenopalatine-ganglion-block-primary-headaches/

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Podcast #312: SCIWORA

Podcast #312: SCIWORA

Author: Sam Killian, M.D. Educational Pearls: Spinal cord injury without radiographic abnormality (SCIWORA) is a diagnosis defined as traumatic injury to spine with clinical sx of traumatic myelopa...

30 Maalis 20184min

Podcast #311: Recurrence of Seizures in Pediatrics

Podcast #311: Recurrence of Seizures in Pediatrics

Author: Aaron Lessen, M.D. Educational Pearls: Recurrence rate for first time unprovoked seizures - 5% after 48 hours, 14% at 2 weeks , 30% after 4 months. Higher risk for recurrence: age under 3; pa...

28 Maalis 20182min

Podcast #310: Bicarb in DKA

Podcast #310: Bicarb in DKA

Author: Gretchen Hinson, M.D. Educational Pearls: Controversial topic. Pathophysiology - acidosis leads to an extracellular potassium shift. Patients in DKA will be intracellularly potassium deplete,...

26 Maalis 20185min

Podcast #309: Return Visits to the ED for UTI

Podcast #309: Return Visits to the ED for UTI

Author: Alicia Oberle, MD Educational Pearls: Recent study has shown risk factors for return included patients at high risk for resistance (nursing home, obstructive uropathy), patient where diagno...

23 Maalis 20182min

Podcast #308: Ultrasound in Cardiac Arrest

Podcast #308: Ultrasound in Cardiac Arrest

Author: Aaron Lessen, M.D. Educational Pearls: There is currently debate within the medical community about what constitutes cardiac activity on ultrasound in the setting of cardiac arrest. A recent ...

21 Maalis 20182min

Podcast #307: Guillain-Barre Syndrome

Podcast #307: Guillain-Barre Syndrome

Author: Peter Bakes, M.D. Educational Pearls: Rare disease with 1-2 patients out of 100,000. About 60% of patients report a preceding diarrheal illness and classically presents with an ascending mo...

19 Maalis 20184min

Podcast #306: Tramadol Drama

Podcast #306: Tramadol Drama

Author: Nick Hatch, M.D. Educational Pearls Tramadol acts at multiple receptors and is a partial agonist at the mu opioid receptor, but also blocks reuptake of serotonin and norepinephrine throughou...

16 Maalis 20183min

Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Podcast #305: Stuffers vs. Packers : Drug-Packet Ingestion

Author: Aaron Lessen, M.D. Educational Pearls A "stuffer" is a term for someone who hastily and conceals a bag of drugs orally/rectally/vaginally in an unplanned situation. A "packer" is someone who...

14 Maalis 20183min

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