Chapter 43 - Code Brown: When the runs run the room! - Management of Acute Diarrheal Emergencies
May 1, 2025
Dive into the messy world of acute diarrhea management in emergency medicine! Learn about the critical role of hydration strategies, including the WHO’s Oral Rehydration Solution. Discover when zinc supplementation may benefit patients, and gain insights into differentiating viral from bacterial causes. The hosts discuss the significance of Complete Blood Count results, the risks of infections like E. coli, and share real case studies for a practical understanding. Join for an engaging exploration of a vital yet often overlooked issue in urgent care!
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insights INSIGHT
Four Mechanisms of Diarrhea
Diarrhea occurs mainly via four mechanisms: secretory, osmotic, exudative/inflammatory, and motility-related.
Each mechanism produces distinct stool characteristics that can guide diagnosis and treatment.
volunteer_activism ADVICE
Key History Questions
Ask about stool quality, frequency, presence of mucus/blood, recent travels or suspicious foods, and immune status.
Inquire about unusual symptoms like paresthesias or palpitations for rare toxin-mediated diarrheas.
volunteer_activism ADVICE
When to Test Stool Pathogens
Order stool culture and pathogen PCR testing mainly in patients with severe symptoms, immunosuppression, travel history, or persistent diarrhea.
Avoid routine testing in mild, self-limited cases to reduce unnecessary diagnostics.
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Diarrhea is one of the more common concerns in emergency medicine worldwide and in the United States, yet we often do not spend enough time understanding the breadth of causes and considerations for this syndrome. Do you know which patients benefit from Zinc? Would you like to review HUS? Can you mixup Oral Rehydration Solution if you needed to? We cover all of this and more in this “code brown” of a chapter! So come, get dirty with Alex and Venk in this truly crappy chapter of Always on EM!
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