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Post-It Pearls

Capsaicin Cream for Cannabinoid Hyperemesis Syndrome

Lin, Michelle MD

doi: 10.1097/01.EEM.0000604552.82229.27
Post-It Pearls



Don't just consider bowel obstruction, gastroparesis, and hyperemesis gravidarum for patients with persistent vomiting. A common unique historical element of frequent hot showers to relieve the vomiting suggests hyperemesis from marijuana use.

A systematic analysis of limited studies and case reports states that applying topical capsaicin cream on the abdomen is a safe and reasonable alternative in addition to traditional antiemetic therapies. (Ann Pharmacother. 2019;53[11]:1145;

This Post-It Pearl first appeared on Dr. Lin's Instagram page: You can find it and other PIPs at

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A Note from Dr. Lin

The Post-It Pearls (PIP) initiative began as a New Year's resolution in 2017 to highlight the amazing bedside teaching that occurs in the emergency department while also teaching the broader emergency medicine community. (

I created the hashtag #PostItPearls on Twitter and Instagram, and am humbled that others in and outside emergency medicine have adopted this digital modality of teaching locally but scaling globally with little extra effort.

PIPs are brief signpost educational pearls not meant to be comprehensive or for the novice practitioner. They assume some level of emergency medicine knowledge. I currently post my PIPs on Instagram @MichelleLinMD, and I challenge and welcome everyone to join me in sharing knowledge bombs with others by using the hashtag #PostItPearls.

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Dr. Linis the founder, CEO, and editor-in-chief of Academic Life in Emergency Medicine ( and a professor of emergency medicine at the University of California San Francisco with interests in health professions education and digital scholarship. Follow her on Instagram @MichelleLinMD and on Twitter @M_Lin.

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