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
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