The Curbsiders Internal Medicine Podcast #438 Recap from SHM #Converge24
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May 6, 2024 A recap from #SHM #Converge24 discussing heart failure, GI bleeds, sepsis, critical care updates, hospital medicine, oncologic emergencies, pneumonia, COPD, transitions of care, vulnerable populations, AI, and more. Topics include POCUS, high-value medical education, molecular testing, periop updates, oral vs IV antibiotics, palliative care, and more!
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Weigh Stability Before Proceeding With Surgery
- For perioperative AF found on the morning of surgery, assess stability, symptoms, valvular disease, and rate before proceeding.
- For post-op troponin use, follow cardiac society guidance but interpret elevated troponin in clinical context.
Reassess Duration For Neutropenic Fever Antibiotics
- MASCC score helps triage neutropenic fever patients for outpatient care, but many centers still admit patients actively on chemotherapy.
- European data support stopping broad antibiotics after 72 hours afebrile with negative cultures even if ANC remains low.
Choose Oral Antibiotics When Appropriate
- Consider oral antibiotics for endocarditis, osteomyelitis, and bacteremia when patients can absorb and follow-up reliably.
- Reserve IV therapy for malabsorption, severe infection, or social reasons preventing reliable oral therapy.