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Latest Episode – Emergency Department Management of Dyspnea in the Dying Patient


EMplify # 18 –Emergency Department Management of Dyspnea in the Dying Patient


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Show Notes

Jeff:Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta. We’ll be taking you through the July 2018 issue of Emergency Medicine Practice: Emergency department management of dyspnea in the dying patient.

Nachi: This month’s issue was authored by two of our former attendings. Dr. Ashley Shreves who is an Emergency and Palliative Care physician at Ochsner Medical Center in New Orleans and Dr. Trevor Pour who is an assistant professor of emergency medicine at the Icahn School of Medicine in New York City. This article was edited by Dr. Ethan Cowan of Mount Sinai Beth Israel and Dr. Michael Turchiano of Maimonides Medical Center.

Jeff: Because ED-related palliative care literature is somewhat sparse, much of the data and recommendations presented in this month’s issue come from studies conducted outside the emergency setting..

Meet the Hosts

Drs. Gupta and Nusbaum are practicing emergency physicians in two of the busiest emergency departments in New York City. Join Jeff, a former firefighter, and Nachi, a former mathematician, as they take you through the July 2018 issue of Emergency Medicine Practice: Emergency department management of dyspnea in the dying patient.

Nachi Gupta, MD, PhD

Jeff Nusbaum, MD

Most Important References
  • 17. Reuben DB, Mor V. Dyspnea in terminally ill cancer patients. Chest. 1986;89(2):234-236. (Prospective; 1754 patients)
  • 34. Lunney JR, Lynn J, Foley DJ, et al. Patterns of functional decline at the end of life. JAMA. 2003;289(18):2387-2392. (Prospective cohort; 4190 patients)
  • 40. Steinhauser KE, Christakis NA, Clipp EC, et al. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000;284(19):2476-2482. (Cross-sectional survey; 1122 patients/families/providers)
  • 41. Quill TE, Arnold R, Back AL. Discussing treatment preferences with patients who want “everything.” Ann Intern Med. 2009;151(5):345-349. (Review)
  • 63. Clemens KE, Quednau I, Klaschik E. Use of oxygen and opioids in the palliation of dyspnoea in hypoxic and non-hypoxic palliative care patients: a prospective study. Support Care Cancer. 2009;17(4):367-377. (Nonrandomized trial; 46 patients)
  • 66. Abernethy AP, McDonald CF, Frith PA, et al. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet. 2010;376(9743):784-793. (Double-blind randomized controlled trial; 239 patients)
  • 68. Galbraith S, Fagan P, Perkins P, et al. Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial. J Pain Symptom Manage. 2010;39(5):831-838. (Randomized controlled crossover trial; 50 patients)
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Meet the Team

Jeff Nusbaum, MD

  • Currently a PGY3 Emergency Medicine resident at The Mount Sinai Hospital, Icahn School of Medicine in NYC
  • Former firefighter and EMT
  • Other Interests: grilling, biking, hiking, New York sports, and delicious snacks (especially from food carts)

Nachi Gupta, MD, PhD

  • Currently a PGY3 Emergency Medicine resident at The Mount Sinai Hospital, Icahn School of Medicine in NYC
  • Former mathematician and worked in missile defense
  • Other Interests: comedy, traveling, cooking, bass guitar, athletics, poker, language

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Last Modified: 07/19/2018
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