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