The Curbsiders Internal Medicine Podcast #465 Hospital Medicine Recap Extravaganza: Diabetic Foot, Sepsis, Syncope, Acute Coronary Syndrome, and more!
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Dec 30, 2024 The hosts take a deep dive into managing diabetic foot infections, discussing essential strategies like debridement and tailored antibiotics. They tackle the urgent management of sepsis, emphasizing prompt fluid resuscitation and the effectiveness of point-of-care ultrasound. Critical patient care strategies are highlighted, particularly in emergency situations, addressing opioid management and syncope. The team also reflects on their experiences over the past year, emphasizing the importance of teamwork and the connections made within the hospital medicine community.
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Goals of Care Discussions
- Have goals of care conversations early in the admission, not during a rapid response.
- Establish clear goals before situations become hectic.
Sickle Cell Pain Management
- Aim for pain control within 60 minutes of a sickle cell patient's arrival and reassess within 60 minutes.
- Utilize PCAs for bolus dosing in patients with outpatient basal opiates, along with scheduled non-opiate analgesics.
Opiate Tolerance vs. Misuse
- High opiate tolerance in sickle cell patients is often misconstrued as misuse.
- Recognize that apparent overuse may stem from physiological tolerance, not addiction.