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SGEM#169: Stuck in the Middle with Food (Glucagon for Esophageal Foreign Body Impaction)

Posted by on Feb 5, 2017 in Featured, GastroIntestinal, Podcasts | 3 comments

Podcast Link: SGEM169 Date: February 2nd, 2017 Reference: Bodkin et al. Effectiveness of glucagon in relieving esophageal foreign body impaction: a multicenter study. AJEM June of 2016 Guest Skeptic: : Meghan Groth (@EMpharmGirl) is an emergency medicine pharmacist. She has contributed to the Academic Life in Emergency Medicine (AliEM) and Emergency Medicine PharmD blogs, and is a member of the ALiEMU Capsules team. Case: It’s the day after St. Patrick’s Day, and you have a 28-year-old man that presents to the emergency department with difficulty swallowing. He was enjoying a feast of corned beef and cabbage several hours prior to arrival when he said it felt like “something got stuck” in his throat. He does have a history of esophageal strictures, and this has happened to him before but he thought if he washed the food down with enough Guinness he wouldn’t have a problem.  Background: Esophageal foreign body impaction (EFBI) is the most common foreign body impaction seen in emergency departments in the United States and accounts for about 75% of cases. Although estimates vary, the majority of foreign body impactions are meat boluses. In addition, the clinical presentation of these cases is complicated by the presence of baseline esophageal pathology, ranging anywhere from 30 to 90% (Weant and Weant, Eisen et al, Sodeman et al, Al-Haddad et al...

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SGEM#168: HYPRESS – Doesn’t Got the Power

Posted by on Jan 22, 2017 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM168 Date: January 19th, 2017 Reference: Keh D et al. Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis: The HYPRESS Randomized clinical Trial. JAMA 2016. Guest Skeptic: Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas. He is the founder and creator of REBEL EM and REBEL Cast as well as the co-creator and co-founder of the Teaching Institute, a medical education startup company trying to change the world of medical education.  Case: A 66-year-old female comes to the emergency department with fever and cough. She has a past medical history of diabetes mellitus, hypertension, and hyperlipidemia. Initial vital signs show a blood pressure of 154/87 mmHg, heart rate 132 beats per minute, respiratory rate 28 breaths per minute, oxygen saturation of 94% on room air, and an oral temperature of 101.9 degrees Fahrenheit (38.8C). You get two peripheral intravenous lines, place the patient on two litres of oxygen by nasal cannula, and hook them up to the cardiac monitor. You begin with a two litre normal saline bolus, Pan-culture your patient, and give empiric antibiotics for community acquired pneumonia (CAP), as this patient has no risk factors for nosocomial infections. A chest X-ray confirms your suspicion of CAP. Despite aggressive intravenous fluids...

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SGEM Xtra: CAEP Choosing Wisely

Posted by on Dec 28, 2016 in Featured, Holiday, Podcasts | 0 comments

Podcast Link: SGEM Xtra CAEP Choosing Wisely Date: November 29th, 2016 Guest Skeptic: Dr. Amy Cheng is an Emergency Physician, the Emergency Department Director of Quality Improvement and the Interim Medical Director of Quality and Patient Safety, at St. Michael’s Hospital in Toronto. She is also the National Co-Chair for Choosing Wisely Canada in Emergency Medicine. This is another SGEM Xtra over the holiday season. There are a lot of top ten lists released at this time of year. The...

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SGEM#167: The Management of Bronchiolitis in Community Hospitals

Posted by on Dec 18, 2016 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 12 comments

Podcast Link: SGEM167 Date: December 14th, 2016 Reference: Plint et al. Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study. CJEM November 2016 Guest Skeptic: Dr. Chris Bond. Chris is an emergency physician and clinical lecturer at the University of Calgary. He is currently the host of CAEP Casts, which highlights educational innovations from emergency medicine residency programs across Canada. Chris also has his own #FOAMed blog called Standing on the Corner Minding My Own Business (SOCMOB). Case:...

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SGEM Xtra: MedSkl.com

Posted by on Dec 11, 2016 in Featured, Podcasts | 2 comments

Podcast Link: SGEM Xtra MedSkl.com Date: November 2nd, 2016 Guest Skeptic: Dr. Sanjay Sharma is a professor of ophthalmology and epidemiology at Queen’s University in Kingston, Ontario, Canada. He has authored over 200 research articles and three books including the American Medical Association’s Evidence-Based to Value-Based Medicine. His research is in macular degeneration, health economics and medical education. This is another SGEM Xtra and not a critical review. There are just so many great topics to cover as well as recent publications. Don’t...

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SGEM#166: Which febrile child with sickle cell disease should get a chest x-ray?

Posted by on Dec 4, 2016 in Featured, Hematologic, Pediatrics, Podcasts, Pulmonary | 15 comments

Podcast Link: SGEM166 Date: November 21st, 2016 Reference: Eisenbrown et al. Which Febrile Children with Sickle Cell Disease Need a Chest X-Ray? AEM November 2016 Guest Skeptic: Dr. Corey Heitz is an associate professor of emergency medicine at the Virginia Tech Carilion School of Medicine in Roanoke Virginia. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the AAEM MedEdPORTAL. Case: You are working in the Emergency Department on an overnight pediatric...

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SGEM#165: I Wanna Be Sedated – But Do I Need To Be NPO?

Posted by on Nov 27, 2016 in Featured, Pediatrics, Podcasts, Pulmonary | 4 comments

Podcast Link: SGEM165 Date: November 22nd, 2016 Reference: Beach et al. Major Adverse Events and Relationship of Nil per Os Status in Pediatric Sedation/Anesthesia Outside the Operating Room. Anesthesiology January 2016 Guest Skeptic: Dr. Bob Edmonds has just completed his residence in Emergency Medicine from the University of Missouri in Kansas City. He is now an emergency department staff physician in the US Air Force at Langley Air Force Base. Dr. Edmonds’ Disclaimer: The views and opinions of this podcast and blog...

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SGEM Xtra: Is #FOAMed Scary?

Posted by on Oct 31, 2016 in Featured, Holiday, Podcasts | 0 comments

Podcast Link: SGEM Xtra Is #FOAMed Scary Date: October 26th, 2016 Guest Skeptic: We have a number of guest skeptics for this episode. Dr. Munsif Bhimani is the program director of the CCFP-EM program at Western University. Drs. Kevinjeet Mahngar, Kelsey Cassidy, Jatin Kacker and Ben Fregeau are residents in the CCFP-EM program at Western University. Dr. Sean Ryan is a front line physician working in community emergency departments. This is an SGEM Xtra. From time-to-time we like to pause from our usual structured critical appraisals...

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SGEM#164: Cuts Like a Knife – But you Might Also Need Antibiotics for Uncomplicated Skin Abscesses

Posted by on Oct 17, 2016 in Dermatologic, Featured, Infectious, Podcasts | 4 comments

Podcast Link: SGEM164 Date: October 13th, 2016 Reference: Talan et al. Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. NEJM March 2016 Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant working primarily in rural Missouri in community hospitals. He has international experience in critical care and emergency medicine. He has a new blog called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. He has recently started podcasting and is always looking to expand this...

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SGEM#163: Shuffle off to Buffalo to Talk Thrombolysis for Acute Pulmonary Embolism

Posted by on Oct 10, 2016 in Cardiac, Featured, Podcasts, Pulmonary | 2 comments

Podcast Link: SGEM163 Date: October 6th, 2016 Reference: Piazza et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism. JACC 2015 Guest Skeptic: Dr. Essie Reed is one of the Chief Residents in the Department of Emergency Medicine at the University of Buffalo. Case: A 75-year-old female with a past medical history of hypertension and non-insulin dependent diabetes presents with chest pain. She describes the pain as sharp, stabbing, and exacerbated with deep inspiration....

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SGEM#162: Not Stayin’ Alive More Often with Amiodarone or Lidocaine in OHCA

Posted by on Oct 2, 2016 in Cardiac, Featured, Podcasts | 2 comments

Podcast Link: SGEM162 Date: September 29th, 2016 Reference: Kudenchuk et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. NEJM April 2016 Guest Skeptic: Dr. Rory Spiegel is a clinical instructor at University of Maryland and a recent graduate of Stony Brook’s Resuscitation Fellowship. He writes an excellent blog called EM Nerd, which he describes as nihilistic ramblings. Case: Your local EMS agency has asked your opinion on which anti-arrhythmic medication, if any, their ambulances should stock for the management of ventricular...

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SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes

Posted by on Sep 25, 2016 in Featured, Podcasts, Pulmonary, Trauma | 9 comments

Podcast Link: SGEM161 Date: September 21st, 2016 Reference: Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 2016 Guest Skeptic: Dr. Chris Bond. Chris is an emergency physician and clinical lecturer at the University of Calgary. He is currently the host of CAEP Casts, which highlights educational innovations from emergency medicine residency programs across Canada. Chris also has his own #FOAMed blog called Standing on the Corner Minding...

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