Saturday, February 4, 2006

Death rattle; radiotherapy complications; AAHPM

Three things:

I happened upon a short, interesting review of the death rattle in Neurocritical Care from 2005. It focuses on the incidence and treatment of the death rattle in the ICU, as well as managing family distress regarding it. My response, somewhat counter to the focus of this hyoscine-for-everything-review, is that pre-education of family members prior to terminal extubations in the ICU is mandatory--focusing especially on warning them that abnormal breathing is to be expected and is not necessarily a sign of suffering.

Lancet Oncology has published a nice review on the oral complications of radiotherapy. It covers the pathogenesis, prevention, and treatment of mucositis, xerostomia, osteoradionecrosis, and trismus. Like many articles in LO it seems quite enamored with basic science and less interested in practical, clinical information, but oh well. It does have some very nice photos and would make a good addition to one's teaching file.

I'm going to be at the AAHPM conference in Nashville most of next week and imagine I won't be blogging much if at all. I am participating in the Fellows' Case Conference Friday afternoon (4:30-6pm; session #423). I will be discussing the management of hospice patients who have ongoing substance abuse problems. It will rock your world. Seriously though--there are some fantastic sounding sessions occurring concurrently, that will probably rock your world more, but what can I do? Come up and say Hi if you want. I have a sneaking suspicion Christian will be there too, if he's not too busy cavorting with drug reps.

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