Wednesday Wrap-Up 10/29/14

We had some great discussion on the various papers for our Case-Based Learning Series. Thanks to Dr.’s Isaksen, Silverberg, and Gernsheimer for their wisdom and time.

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1.  Brooklyn is a huge place with a diverse population and a broken healthcare system

2.  DSRIP – Delivery System Reform Incentive Payment is an opportunity to transform healthcare in Brooklyn with the goal of decreasing ED and hospital use.

3.  Decreasing ED visits may not be the right strategy to improve health outcomes.

4.  Physicians need to be engaged in this process.

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GI Decontamination Strategies – Depends on who you ask.

1. Cathartics – limited utility beyond first activated charcoal
– Never use alone
2.  Ipecac – Limited application, vanishing
3.  Lavage – Useful emptying procedure

                  – Shouldn’t be abandoned
4. Whole bowel irrigation – When indicated (not absorbed by charcoal, sustained release preparations,GI drug smuggling)
– Not studied
5. Manage many with AC alone

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By Dr. Andrew Grock, Dr. Jay Khadpe, and Dr. Carl Alsup