The Curbsiders Internal Medicine Podcast #414 Spooky Cakes: VKA vs DOACs in Frail Adults, RSV Vaccine, Cuff Size Matters, Bloating & Belching, AKI & Pip-Tazo
6 snips
Oct 30, 2023 
Medical experts Paul Williams, Rahul Ganatra, and Matt Watto discuss VKAs vs DOACs in frail adults, RSV vaccine efficacy in older adults, importance of correct blood pressure cuff size, cotton fever in drug users, new bloating and belching guidelines, and AKI risk of pip-tazo.
AI Snips
Chapters
Transcript
Episode notes
Use Correct Blood Pressure Cuff Size
- Measure arm circumference and choose the correct BP cuff size rather than defaulting to the regular cuff.
- Using a cuff too small can overestimate BP by ~20 mmHg; too large can underestimate by ~3 mmHg.
Study May Underestimate Real-World Error
- The study's mean BMI was 28, so cuff-size mismatch effects may be larger in heavier patients.
- Real-world mismeasurement may be underestimated by this trial's sample.
Use Shared Decision-Making For RSV Vaccine
- Discuss RSV vaccine for adults ≥60 through shared decision-making, prioritizing those with cardiopulmonary disease.
- Tell patients the vaccine reduces symptomatic RSV but evidence for preventing hospitalization or death is not yet definitive.