Podcast 653: Nitroglycerin Disimpaction

Podcast 653: Nitroglycerin Disimpaction

Contributor: Ricky Dhaliwal, MD, JD

Educational Pearls:

  • Glucagon administered intravenously has a high rate of adverse events (nausea/vomiting) with very weak evidence
  • NItroglycerin too has very limited evidence but a much better adverse event profile
    • Mix 0.4 mg (1 sublingual tablet) nitro in 10 mL of water and administer orally
  • Nothing beats upper endoscopy for effectiveness but in settings where GI is not immediately available, nitroglycerin may be worth an attempt given its better safety profile to other medications

References

Arora S, Galich P. Myth: glucagon is an effective first-line therapy for esophageal foreign body impaction. CJEM 2015;11:169–71

Schimmel J, Slauson S. Swallowed Nitroglycerin to Treat Esophageal Food Impaction. Ann Emerg Med. 2019 Sep;74(3):462-463.

Summarized/Edited by Erik Verzemnieks, MD

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Podcast 686: Vaginal Self Swabs

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Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Contributor: Dr. Nick Gorton, MD Educational Pearls: Use transgender people's correct names and pronouns, the Russell study found a 56% reduction in suicide behavior with chosen name usage ⅕ to ½ of ...

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Podcast 684: Acidosis

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Contributor:  Nick Tsipis, MD Educational Pearls: pH 7.45=alkalemia If pH low and pCO2 high, indicates a respiratory acidosis If pH low and pCO2 low, indicates metabolic acidosis After determining ty...

23 Kesä 20216min

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Contributor: Jared Scott, MD Educational Pearls: Around 30 patients with cannabinoid hyperemesis syndrome (CHS) randomized treatment in three arms with 8mg Zofran, Haldol 0.05 mg/kg, and Haldol 0.1 ...

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Podcast 682: Snake Bites

Podcast 682: Snake Bites

Contributor: Gretchen Hinson, MD Educational Pearls: Pit vipers include cottonmouths, rattlesnakes, and copperheads All have folding long fangs, triangular face, and elliptical pupils About 5,00...

21 Kesä 20216min

Podcast 681: Internal Hernias

Podcast 681: Internal Hernias

Contributor: Adam Barkin, MD Educational Pearls: Internal hernias, when bowel herniates through iatrogenic or congenital defect in mesentery, represent 1-6% of all small bowel obstructions Mortality...

16 Kesä 20215min

Podcast 680: Coronary Artery Dissection

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Contributor: Adam Barkin, MD Educational Pearls: Spontaneous coronary artery dissection (SCAD) is the most common cause of acute MI in women under 50 years old Risk factors include fibromuscular dys...

15 Kesä 20214min

Podcast 679: Antibiotics for CAP

Podcast 679: Antibiotics for CAP

Contributor: Peter Bakes, MD Educational Pearls: Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment For outpatient treatment,...

9 Kesä 20217min

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