Comments for ercast.org http://blog.ercast.org Emergency medicine podcasts, reviews and curbside consults Sun, 12 Feb 2012 22:00:19 +0000 hourly 1 http://wordpress.org/?v=3.3.1 Comment on The Constipation Manifesto by Joel Wienshttp://blog.ercast.org/2012/02/the-constipation-manifesto/#comment-243 Joel Wiens Sun, 12 Feb 2012 22:00:19 +0000 http://blog.ercast.org/?p=1160#comment-243 Hey - was just listening to Larry Raney's lecture on the effectiveness of non-opioid analgesics over at Joe Lex's site and his last 2 minutes on Ketamine made me think of your podcast on constipation. How about pain dosed ketamine for narcotic bowel while you are taking them off dilaudid to get their bowels moving again? I'm sure there are no studies on this, but what do you think? Hey -- was just listening to Larry Raney’s lecture on the effectiveness of non-opioid analgesics over at Joe Lex’s site and his last 2 minutes on Ketamine made me think of your podcast on constipation. How about pain dosed ketamine for narcotic bowel while you are taking them off dilaudid to get their bowels moving again? I’m sure there are no studies on this, but what do you think?

]]> Comment on Constipation Manifesto – references and recommended reading by Rob Ormanhttp://blog.ercast.org/2012/02/constipation-manifesto-references-and-recommended-reading/#comment-239 Rob Orman Fri, 10 Feb 2012 00:34:03 +0000 http://blog.ercast.org/?p=1133#comment-239 Hi Don, the deal with hyponatremia is that Miralax, which does not contain electrolytes, may lead to hyponatremia when ingested in large volumes. The problem, in theory, is that patients will consume too much free water on top of the PEG-water elixir that they are using for laxation. Go-lytely, which has added electrolytes such as sodium and potassium, is felt to decrease the risk. I personally don't think there is much of a difference when the amount consumed is 1 glass per day, but when we get into disimpaction dosing, which involves many doses per day, the issue of free water consumption is more relevant. Hi Don, the deal with hyponatremia is that Miralax, which does not contain electrolytes, may lead to hyponatremia when ingested in large volumes. The problem, in theory, is that patients will consume too much free water on top of the PEG-water elixir that they are using for laxation. Go-lytely, which has added electrolytes such as sodium and potassium, is felt to decrease the risk. I personally don’t think there is much of a difference when the amount consumed is 1 glass per day, but when we get into disimpaction dosing, which involves many doses per day, the issue of free water consumption is more relevant.

]]> Comment on Constipation Manifesto – references and recommended reading by Don zweighttp://blog.ercast.org/2012/02/constipation-manifesto-references-and-recommended-reading/#comment-238 Don zweig Fri, 10 Feb 2012 00:27:06 +0000 http://blog.ercast.org/?p=1133#comment-238 Recipe for Zdoggs bomb? How much glycerin and in what form? How much water ? Recipe for Zdoggs bomb? How much glycerin and in what form? How much water ?

]]> Comment on Constipation Manifesto – references and recommended reading by Chris Martinezhttp://blog.ercast.org/2012/02/constipation-manifesto-references-and-recommended-reading/#comment-237 Chris Martinez Fri, 10 Feb 2012 00:17:36 +0000 http://blog.ercast.org/?p=1133#comment-237 I've been waiting years for this bit of excrement! So I'm not the only witless one sent into a room to clean a chute without a clue. Thanks for bringing light to a dark brown subject. I’ve been waiting years for this bit of excrement! So I’m not the only witless one sent into a room to clean a chute without a clue. Thanks for bringing light to a dark brown subject.

]]> Comment on Constipation Manifesto – references and recommended reading by donhttp://blog.ercast.org/2012/02/constipation-manifesto-references-and-recommended-reading/#comment-229 don Fri, 03 Feb 2012 21:23:00 +0000 http://blog.ercast.org/?p=1133#comment-229 also, i was a little confused about the electrolyte free vs electrolyte containing forms of peg. can you explain or provide a reference? what is in the traditional go lytley.?what is the advantage of either?btw, loved the pod cast-my favorite to date. i laughed re. the disimpaction because i too always wondered where the section in Roberts and Hedges is on the proper technique. i often use ketafol to do it. also, i was a little confused about the electrolyte free vs electrolyte containing forms of peg. can you explain or provide a reference? what is in the traditional go lytley.?what is the advantage of either?

btw, loved the pod cast-my favorite to date. i laughed re. the disimpaction because i too always wondered where the section in Roberts and Hedges is on the proper technique. i often use ketafol to do it.

]]> Comment on Constipation Manifesto – references and recommended reading by donhttp://blog.ercast.org/2012/02/constipation-manifesto-references-and-recommended-reading/#comment-228 don Fri, 03 Feb 2012 21:20:05 +0000 http://blog.ercast.org/?p=1133#comment-228 what is the recipe for the "bomb enema" that zdogg spoke of.? like, how much glycerin and in what form and who much mag citrate and how much whatever else ?i would also like to make a plug (pun intended) for milk and molasses enema- we use one cup of whole milk and one cup molasses warmed in a microwave. what is the recipe for the “bomb enema” that zdogg spoke of.? like, how much glycerin and in what form and who much mag citrate and how much whatever else ?

i would also like to make a plug (pun intended) for milk and molasses enema- we use one cup of whole milk and one cup molasses warmed in a microwave.

]]> Comment on Suicide risk assessment in the ER by JDiddyhttp://blog.ercast.org/2011/09/suicide-risk-assessment-in-the-er/#comment-224 JDiddy Tue, 31 Jan 2012 04:02:56 +0000 http://ercastblog.wordpress.com/?p=404#comment-224 Rob O I'm sorry I totally goat fornicated the link:https://www.npr.org/blogs/health/2012/01/30/145992588/could-a-club-drug-offer-almost-immediate-relief-from-depression?sc=fb&cc=fp Rob O I’m sorry I totally goat fornicated the link:

https://www.npr.org/blogs/health/2012/01/30/145992588/could-a-club-drug-offer-almost-immediate-relief-from-depression?sc=fb&cc=fp

]]> Comment on Suicide risk assessment in the ER by JDiddyhttp://blog.ercast.org/2011/09/suicide-risk-assessment-in-the-er/#comment-223 JDiddy Tue, 31 Jan 2012 00:52:06 +0000 http://ercastblog.wordpress.com/?p=404#comment-223 Rob O, so dig this:http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=130493013&m=130514041Ketamine for immediate relief of depression....wow..... Rob O, so dig this:

http://www.npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=130493013&m=130514041

Ketamine for immediate relief of depression….wow…..

]]> Comment on Zen and the Art of Shoulder Reduction by Dustinhttp://blog.ercast.org/2012/01/zen-and-the-art-of-shoulder-reduction/#comment-221 Dustin Fri, 27 Jan 2012 16:14:55 +0000 http://blog.ercast.org/?p=1014#comment-221 I like it! I've tried scapular manipulation to evade the need to use procedural sedation but have had limited results. It's hard to get some people into the position for that technique and I think the Cunningham technique might be easier for people because they can stay seated. I also like to inject the capsule with lidocaine and then just do external rotation/abduction.One thing from the video though, where were the other patients asking for their discharge papers, "where's my Percocet", "I haven't got my sandwich yet", and the "Wet" patient screaming in the backround? I like it! I’ve tried scapular manipulation to evade the need to use procedural sedation but have had limited results. It’s hard to get some people into the position for that technique and I think the Cunningham technique might be easier for people because they can stay seated. I also like to inject the capsule with lidocaine and then just do external rotation/abduction.

One thing from the video though, where were the other patients asking for their discharge papers, “where’s my Percocet”, “I haven’t got my sandwich yet”, and the “Wet” patient screaming in the backround?

]]> Comment on Pediatric fever by Greg Hartthttp://blog.ercast.org/2011/12/pediatric-fever/#comment-219 Greg Hartt Thu, 26 Jan 2012 12:19:42 +0000 http://blog.ercast.org/?p=904#comment-219 Rob, I've noticed that more docs are ordering only single blood cultures on peds. I'm not talking about the <28 days, where 2 are still routine. But pediatricians in the community seem to be supportive of the single blood cx concept in older kids. My thoughts are that with the immunized kids and herd immunity, since the incidence of SBI is so low, we (the general med community) have anecdotally determined that the utility of blood cultures is low. My practice is to order 2 cultures, in patients that I think need them. Otherwise, I don't order any. I am unaware of any evidence to support the one culture practice. Any thoughts on this? Rob, I’ve noticed that more docs are ordering only single blood cultures on peds. I’m not talking about the <28 days, where 2 are still routine. But pediatricians in the community seem to be supportive of the single blood cx concept in older kids. My thoughts are that with the immunized kids and herd immunity, since the incidence of SBI is so low, we (the general med community) have anecdotally determined that the utility of blood cultures is low. My practice is to order 2 cultures, in patients that I think need them. Otherwise, I don't order any. I am unaware of any evidence to support the one culture practice. Any thoughts on this?

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