Saturday, April 25, 2009
Highlights from Internal Medicine 2009
At a Thursday afternoon session, Jason Persoff, MD, reminded his audience of the high stakes involved when dealing with cardiac resuscitation. Even when CPR is done perfectly, he noted during "Shocking Developments in Resuscitation: Cold Compressions and Clinical Updates," it yields only one-third of the normal cardiac output, 10% to 15% of normal cerebral blood flow, and 1% to 5% of normal cardiac blood flow. And perfect CPR is rare: Dr. Persoff cited a study showing that chest compressions are too shallow about 63% of the time and too slow about 72% of the time. As for defibrillation, it's often not done quickly enough, Dr. Persoff said. He advised attendees to shock first, ask questions about rhythm later.
On Friday, Dennis G. Maki, MACP, delivered a lecture on "Emerging Infectious Diseases" that focused in part on C. difficile-associated disease (CDAD). Rates of CDAD are increasing "precipitously," he noted, because of more variable strains and an older, more susceptible population. He also pointed to another possible culprit: alcohol-based handrubs. Because spores can't be killed by alcohol gels, Dr. Maki recommends good old-fashioned handwashing instead.
Finally, at a Saturday afternoon session on "Pain Management in the Hospitalized Patient," Eva H. Chittenden, FACP, offered attendees a thorough review of best practices, including appropriate use of opioids and other medications. Although completely relieving pain isn't always possible, Dr. Chittenden said, clinicians can focus on reducing it to a level that's tolerable for the patient. "We have to believe our patients when they say they have pain," she said, "because they're the only ones who can tell us."
For more in-depth coverage of Internal Medicine 2009 sessions, check out the June issue of ACP Hospitalist.
Labels: cardiology, infectious diseases, Internal Medicine 2009, pain management, palliative care
posted by Jennifer Kearney-Strouse at
12:23 PM
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Previous Posts
Blog log
Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:
Albert Fuchs, MD
Albert Fuchs, MD, FACP,
graduated from the University of California, Los Angeles School of
Medicine, where he also did his internal medicine training.
Certified by the American Board of Internal Medicine, Dr. Fuchs
spent three years as a full-time faculty member at UCLA School of
Medicine before opening his private practice in Beverly Hills in
2000.
David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned
authority on nutrition, weight management, and the prevention of
chronic disease, and an internationally recognized leader in
integrative medicine and patient-centered care.
DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about
health topics for patients and health professionals.
Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more
than a decade and is an Associate Professor of Medicine at an
academic medical center on the East Coast. His time is split
between teaching medical students and residents, and caring for
patients.
Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science,
medicine, health and healing in the 21st century.
FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the
Internal Medicine Residency and Assistant Dean of Scholarship &
Discovery at the Pritzker School of Medicine for the University of
Chicago. Her education and research focus is on resident duty
hours, patient handoffs, medical professionalism, and quality of
hospital care. She is also an academic hospitalist.
Glass
Hospital
John H. Schumann, MD, FACP, provides transparency on the workings
of medical practice and the complexities of hospital care,
illuminates the emotional and cognitive aspects of caregiving and
decision-making from the perspective of an active primary care
physician, and offers behind-the-scenes portraits of hospital
sanctums and the people who inhabit them.
Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the
University of North Carolina School of Medicine, and the Program
Director for the GI & Hepatology Fellowship Program. He
specializes in diseases of the esophagus, with a strong interest in
the diagnosis and treatment of patients who have
difficult-to-manage esophageal problems such as refractory GERD,
heartburn, and chest pain.
I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic
hospitalist with an interest in basic and clinical science and
education, with interests in noninvasive monitoring and diagnostic
testing using novel bedside imaging modalities, diagnostic
reasoning, medical informatics, new medical education modalities,
pre-code/code management, palliative care, patient-physician
communication, quality improvement, and quantitative biomedical
imaging.
Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.
KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites
for influential health commentary.
MD
Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of
medical practice, including controversies in the doctor-patient
relationship, medical ethics and measuring medical quality. When
he's not writing, he's performing colonoscopies.
Medical
Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education,
ethics in medicine, health care news and culture. Her views on
medicine are informed by her past experiences in caring for
patients, as a researcher in cancer immunology, and as a patient
who's had breast cancer.
Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a
small community hospital in Connecticut. His blog is a series of
musings on medicine, medical care, the health care system and
medical ethics, in no particular order.
Reflections
of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being
a doctor in a community hospital in Atlanta.
Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in
education, social media and networking, practice management and
evidence-based medicine tools, personal information and knowledge
management.
White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and
teaching physician in Southeast Michigan. The blog, which has been
around in various forms since 2007, offers musings on the
intersection of science, medicine, and culture.
ACP Internist and ACP Hospitalist also contribute to and draw upon content from Get Better Health, a network created by Val Jones, MD, to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the clinician's point of view on health care reform, science, research and patient care.
Other blogs of note:
American
Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine
publishes original clinical articles of interest to physicians in
internal medicine and its subspecialities, both in academia and
community-based practice.
Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP
Member, associate program director at New York University Medical
Center's internal medicine residency program. Faculty, residents
and students contribute case studies, mystery quizzes, news,
commentary and more.
db's Medical
Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating
medicine and the health care system.
Interact
MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so
he can create an independent, clinician-reviewed space on the
Internet for physicians to report and comment on the medical news
of the day.
PLoS
Blog
The Public Library of Science's open access materials include a
blog.
White Coat Rants
One of the most popular anonymous blogs written by an emergency
room physician.
4 Comments:
This comment has been removed by a blog administrator.
I still feel it is better to try CPR badly than to walk away and wonder if you could have helped. It is true the 'success' rate is low but it is still worthwhile ordinary people knowing what to do. 30 compressions and then 2 breaths and keep repeating is not hard to remember
How could you not try CPR? It is our duty and moral obligation to help. What if the tables were turned?
New CPR Guidelines were released in Australia in 2010. Yes we do learn CPR 'Down Under'! With a large population living near the beach it is essential.
CPR Training Guideline changes to DRS ABCD:
D Check for Danger
R Check for Responsiveness
S Send for help
A Open Airway
B Check for normal Breathing
C Start CPR - 30 chest impressions: 2 rescue breaths
D Attach defibrillator (AED) as soon as available and follow prompts
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