ASGE Peroral Endoscopic Myotomy (POEM) Pearls to Practice: LIVE and Virtual

Video Transcription

Video Summary

In this video, Joe Triggs from the University of Pennsylvania discusses post-polarity hematoma management. He begins by discussing his order set and how he takes care of patients immediately after polarity. He emphasizes the importance of thinking about discharge planning early in the admission and considers factors such as patient health status and the distance they have to travel. Triggs mentions a study that found that 62% of patients can be safely discharged the same day as the procedure, with only two patients requiring follow-up imaging. He also discusses indications for admission, including chest pain requiring opiates, fever, adverse events during the procedure, and medical comorbidities. Triggs then talks about pain management after polarity, noting that most patients experience some pain, but it typically resolves quickly. He discusses his pain management regimen, which includes IV dilaudid and Tylenol, and mentions that he no longer sends patients home with opiates unless they absolutely need them. Triggs also discusses post-polarity diet, noting that there is no consensus on the best diet and recommendations range from two to seven days of liquids and two to three weeks of soft foods. He also touches on topics such as acid suppression after polarity, antibiotics, and the management of patients on antiplatelet and anticoagulant therapy. Triggs concludes by mentioning the importance of long-term follow-up after polarity to assess for symptom recurrence and potential complications. He notes that while there is no consensus on the ideal follow-up schedule, he personally follows up with his patients annually with either an esophogram or an EGD.

Asset Subtitle

Triggs

Keywords

post-polarity hematoma management

discharge planning

patient health status

follow-up imaging

pain management after polarity

post-polarity diet

long-term follow-up