Vicky Price from the Society of Acute Medicine discusses the synergy between acute and emergency medicine. They explore challenges in collaboration between departments, addressing workload pressures and advocating for unified patient care. The podcast also delves into the impact of administering antibiotics to brain injury patients to prevent pneumonia and improve outcomes.
IV fluids in hyperemesis gravidarum should avoid dextrose to prevent Wernicke's encephalopathy.
Weighing patients to assess dehydration severity is vital in hyperemesis gravidarum management.
Risk assessment and red flag identification are crucial for severe hyperemesis gravidarum cases.
Patient education on antiemetic safety, like Ondansetron, is essential for informed decision-making.
Deep dives
Treatment Recommendations for Hyperemesis Gravidarum
Medications like Zofran and Metoclopramide are recommended as first and second line treatments for hyperemesis gravidarum. IV fluids should be administered cautiously with avoidance of dextrose-containing fluids to prevent Wernicke's encephalopathy. Consideration should be given to community care first with oral antiemetics and dietary advice before escalating to IV antiemetics if needed.
Importance of Weight Monitoring in Hyperemesis Gravidarum
Weighing patients in the emergency department can be crucial in evaluating the extent of dehydration and impact on body weight due to severe vomiting associated with hyperemesis gravidarum. Tracking weight changes and fluid balance can guide appropriate treatment decisions.
Risk Assessment Highlighted in Hyperemesis Gravidarum
The guideline underscores the importance of risk assessment and red flag identification for severe cases of hyperemesis gravidarum. Adverse health outcomes in children born to mothers with this condition are mentioned, along with associations with postnatal depression and PTSD, emphasizing the need for comprehensive care for both the mother and child.
Medication Safety and Patient Education
Patient education around medication safety, especially regarding possible risks and benefits of antiemetic use like on Dansetron, is crucial. Shared decision-making with patients should consider the available evidence on the impact of medications on pregnancy outcomes, highlighting the need for informed choices.
Prophylactic Antibiotics for Patients with Acute Brain Injury
A study explores the use of a single dose of keftriaxone as a prophylactic measure to prevent ventilator-associated pneumonia in patients with acute brain injury. The trial showed a significant reduction in early VAP incidence and mortality in the keftriaxone group compared to placebo, indicating a potential beneficial impact on outcomes. The study raises the possibility of a simple intervention that could improve outcomes in this patient population.
Departmental Handover Best Practices
Charlotte Davies discusses the importance of effective departmental handovers in mitigating risks in emergency settings. The article provides tips and strategies for constructing good handovers to ensure effective communication and patient safety during shift changes.
Recognizing Pediatric Sepsis and Fever
Edward Snelson and Hannah Walsh's article on recognizing pediatric sepsis and fever highlights the challenges in diagnosing sepsis in children with febrile presentations. The piece offers insights on definitions, investigations, and considerations for identifying sepsis in pediatric patients, aiming to provide valuable tools for healthcare professionals.
Congenital Cardiac Disease Overview
Fatima Jaffa and Reata Sane's article delves into congenital cardiac diseases, exploring common conditions and management strategies. The resource aims to enhance understanding of complex congenital heart conditions through detailed explanations and illustrative diagrams, serving as a valuable reference for healthcare professionals dealing with pediatric cardiac cases.
Happy April! This month for the April 2024 episode of the RCEM Learning Podcast Rob and Liz have got two New in EM segments with Andy and Dave looking at ondansetron in ketamine sedation and the use of antibotics in brain injury. We have a Guidelines for EM looking at the management of hyperemesis gravidarum and we have an interview with Vicky Price from the Society of Acute Medicine. We then end with New Online. If you'd like to email us, please feel free to do so here
(04:56) New in EM - Ondansetron in ketamine sedation
