Salim R. Rezaie, MD Profile picture
EM/IM Doc; Founder of REBEL EM; Medical Director at IA MED; Doing my Part to Cut Down on KT Time; Viva #FOAMed #FOAMcc (Tweets are opinion only)

Oct 25, 2021, 6 tweets

Cruising the Literature: Updates in GI Emergencies at #ACEP21

-CODA: Abx 1st vs Surgery 1st for Appendicitis
-HALT-IT: TXA for GIBs
-Timing of Endoscopy in GIBs
-Topical Capsaicin Cream for Cannaboid Hyperemesis
-Inhaled Isopropyl Alcohol for N/V

CODA: Abx 1st vs Surgery 1st for Appendicitis

rebelem.com/rebel-cast-ep-…

-Abx non-inferior to surgery BUT...
-Appendectomy in 30% by 90d
-3x more ED visits
-2x more complications
-Appendicoliths higher risk for complications

HALT-IT: TXA for GIBs

rebelem.com/rebel-cast-ep8…

-No Benefit
-Increased Harms
-Timing of GIB Difficult

Timing of Endoscopy in GIB

rebelem.com/rebel-cast-ep8…

-HD Stable = Optimize Medical Conditions 1st
-HD Unstable = Resuscitate+Medical Tx+Endoscopy ASAP
-GI: HD Unstable Pts Get Earlier Endoscopy BUT do Worse
-ED: Do worse because they are just sicker not from endoscopy itself

Topical Capsaicin Cream in Cannaboid Hyperemesis

rebelem.com/topical-capsai…

-Worth a shot
-Low cost
-Widely available
-Low adverse event profile

BOTTOM LINES: Cruising the Literature: Updates in GI Emergencies at #ACEP21

-Appendicoliths = Complicated Appendicitis
-TXA for GIB = NO Benefit
-HD Stable GIB = Optimize Medical Conditions 1st
-Cannabis Hyperemesis = Try Capsaicin
-N/V + No IV = Try Inhaled Isopropyl Swabs

Share this Scrolly Tale with your friends.

A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.

Keep scrolling