#156 Hospice 101: Nuts and Bolts

How is TPN and PPN similar and how is it different? When should each be used? How does bacterial overgrowth lead to complications? Does TPN cause diarrhea?** Register for 2025 Digital Education & Artificial Intelligence Conference !! **It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.Timestamps:(01:35) | PEARL 1: Basics of PN: What makes up parenteral nutrition?(06:54) | PEARL 2: Indications and Contraindications for TPN and PPN: When should I order parenteral nutrition?(13:40) | PEARL 3: Complications of parenteral nutrition: What are the common adverse effects of parenteral nutrition?(19:41) | PEARL 4: Parenteral nutrition myths: What should patients know before they start TPN?(23:56) | PEARL 5: Recap on Tube Feeds: How do we determine the amount of free water to give out patients on tube feeds?Transcript and Show notesTags: IMCore, CoreIM, parenteral nutrition, TPN, PPN, clinical nutrition, nutritional support, complications, patient safety, gastrointestinal disorders, critical care, internal medicine, fluid management, ICU, Crit Care, GI, gastroenterology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Limitations to urine drug screening (UDS) in primary care? What are common false positives and false negatives with the urine drug screen test?** Register for 2025 Digital Education & Artificial Intelligence Conference !! **It will be an inspiring day filled with hands-on workshops and expert panels designed to empower educators with practical digital media and AI tools.Timestamps:(03:01) | PEARL 1: Basics to Urine Drug Screen (UDS)(08:03) | PEARL 2: Types of urine drug tests, and what are immunoassays (IA)?(18:44) | PEARL 3: What are gas chromatography/mass spectrometry (GC/MS)-based tests?(26:51) | PEARL 4: How do you address unexpected test results on a UDS?(30:29) | PEARL 5: Throwback to “5 Pearls on Stigma in Opioid Use Disorder” episodeTranscript and Show notesTags: IMCore, CoreIM, primary care, urine drug screening, opioid use disorder, substance use, harm reduction, addiction medicine, clinical toxicology, patient safety, compassionate careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What if a patient can't afford hospice? Which medications do you deprescribe when on hospice? What happens when patients who are on hospice return to the hospital or ED?Behind the Scenes Youtube Interview:Hospice Music TherapyShow notes & TranscriptHospice 101 Episode 1Sponsor:Imagine leveraging A.I to do pre-charting before seeing a patient. Reach out to [email protected] to integrate Glass A.I into your EMR!For more on Glass or Glass Pro, use the promo code: CoreIMTags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Can the MINT trial change how we treat anemia in acute MI? The largest trial of its kind compared liberal vs. restrictive transfusion strategies in patients with myocardial infarction.Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTimestamp:01:29 History of Transfusion Guidelines/Studies06:49 Pathophysiology of Anemia in heart disease10:04 Transfusion in MI Studies13:45 MINT Trial22:20 Takeaways/DiscussionTranscript and Show NotesTags: Tags: CoreIM, IMCore, cardiology, internal medicine, myocardial infarction, anemia, transfusion, physician assistant, nurse practitioner, pharmacist, clinical trials, MINT trial, transfusion strategies, restrictive vs. liberal transfusion, heart attackFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Strategies to address moral distress and moral injury — hear from the experts on their work on the topic!Timestamps:(01:07) | Strategies for Addressing Moral Distress(09:25) | Strategies for Address Moral Injury(20:52) | ConclusionTranscript and Show notesTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, Medical Humanities, medical ethicsFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians?Sponsor: Whether you're looking to open your own practice or buy into a group, Panacea Financial understands the unique needs of physicians and offers tailored financial solutions. Timestamps:(04:59) | Definitions(6:50) | Moral Distress(09:01) | Moral Residue(09:01) | Moral Residue(11:34) | Moral Injury(13:32) | Causes of Moral Distress and Moral Injury(18:18) | ConsequencesTranscript and Show notesTags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanismFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!”Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTimestamps:(01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension(09:57) | Case 2: Diuretic Resistance from Low Cardiac Output(26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion PressureTranscript and Show notesCardiorenal Considerations: 5 Pearls SegmentTags:IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical careFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team.Sponsor: Glass Health is a platform that empower clinicians with best-in-class AI for clinical decision supportUse promo code COREIM for 1 month of free access to Glass Pro for unlimited A.I queries !Timestamps:(2:44) What makes this patient different from others with similar symptoms or diagnosis?(7:28) Does your covering team have the tools to follow up on tasks and information they need for success? (16:06) Is the handoff updated? (18:26) What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? (22:41) What are we still uncertain about? (25:30) Closing thoughts Show notes & transcriptsTags:IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalistFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What is the philosophy of hospice? (3:04)Who qualifies for hospice (6:13)Who makes up the hospice team (8:17)Who pays for hospice (17:24)What are the different levels of care (21:31)What are some limitations of the hospice medicare benefit? (31:57)Behind the Scenes Youtube Interview:Hospice Music TherapyShow notes & TranscriptSponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with FreedTags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention.Book by Dr. Adaira Landry, Dr. Resa E. Lewiss: MicroSkills: Small Actions, Big ImpactShow notes & TranscriptTags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistantFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy