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Read MoreSGEM#230: Tamsulosin – You’ve Lost that Loving Feeling – For Renal Colic
Podcast Link: SGEM230 Date: September 17th, 2018 Reference: Meltzer, A. et al. Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial. JAMA Internal Med, 2018. Guest Skeptics: Dr. Tony Seupaul, Professor and Chair, University of Arkansas for Medical Sciences Department of Emergency Medicine. Dr. Daniel Holleyman, Chief Resident at University of Arkansas for Medical Sciences Emergency Medicine Residency. Case: A 51-year-old man presents to the emergency department (ED) with five-hour history of acute onset left flank pain. The pain comes in waves, radiates into his left groin and is associated with nausea and vomiting. He noticed darkening of his urine, but does not have dysuria, fever, testicular pain, or penile discharge. You work him up and the urine analysis shows large blood, negative nitrites, negative bacteria. CT abdomen/pelvis without contrast is done which identifies a 7mm radiopaque stone in the left distal ureter. The patient receives 15mg ketorolac IV (SGEM#175) because you know there is a ceiling to the analgesic effect of non-steroidal anti-inflammatory drugs (NSAIDs). His pain improves significantly, and he is ready for discharge. He is given a referral to Urology for follow up of his ureteral stone, a prescription for oral antiemetics, and advised to take over-the-counter (OTC) NSAIDs. He asks if there is anything he could do or take to help the stone pass faster? Background: We have covered renal colic many times on the SGEM. This has included the medical expulsive therapy using alpha blockers, lidocaine for pain control, pushing IV fluids or diuretics to pass stones, ultrasound vs. CT scans for diagnosis, and even acupuncture vs. morphine for renal colic pain. SGEM#4: Getting Un-Stoned (Renal Colic and Alpha Blockers) SGEM#32: Stone Me (Fluids and Diuretics for Renal Colic) SGEM#71: Like a Rolling Kidney Stone SGEM#97: Hippy Hippy Shake – Ultrasound Vs. CT Scan for Diagnosing Renal Colic SGEM#154: Here I Go Again, Kidney Stone SGEM#202: Lidocaine for Renal Colic? SGEM#220: Acupuncture Morphine for Renal Colic The SGEM bottom lines on the management of renal colic from those previous episodes were as follows: Expulsive therapy is unnecessary for ureteric stones < 5mm. You don’t need to push fluids (oral/IV) or use diuretics to pass kidney stones. There is some weak evidence that Tamsulosin MAY help passage of larger stones (5 to 10 mm). Bedside emergency department ultrasound is safe and has several advantages over CT for the diagnosis of kidney stones. Lidocaine cannot be recommended for the treatment of renal colic at this time. The evidence does...
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Read MoreSGEM#229: I Fought the Law and the Law Won – But Would it Matter if I had a Resident?
Podcast Link: SGEM229 Date: September 10th, 2018 Reference: Gurley et al. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases. AEM September 2018 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the creator of the excellent #FOAMed project called First10EM.com Case: You are giving an introductory lecture on evidence-based medicine to the incoming class of residents, and after you finish you notice some excited chatter at the back of the room. Thinking that you have found some EBM keeners/gunners, you wander over to join the discussion, but find yourself in a heated discussion. One of the senior residents was recently named in a lawsuit, and the junior residents are worried. How likely are they to be sued? What can they do to prevent such a harrowing event? The residents turn to you, hoping that you can provide some insight on this topic. Background: Unfortunately, physicians are not perfect. Mistakes are made occasionally, and those mistakes can harm our patients. Medical care provided by trainees involves some added risks. In an internal medicine setting, problems with handoffs, teamwork, and lack of supervision were identified as issues in trainee malpractice cases. In Canada, we have a national organization called the Canadian Medical Protective Association (CMPA). The CMPA has approximately 97,000 members representing 95% of Canadian physicians. There are about 10,000 files opened every year with 38% involving payouts. Only 8% of cases end up in court. There has been a 5% decrease in cases over the last decade. It is important to note that our medical-legal environment in Canada is much different than in the United States. It is a much more litigious system south of the border. The paper we will be talking about today come out of the US. Clinical Question: What are some of the key factors in malpractice claims against trainees, and how do those compare to malpractice cases that don’t involve trainees? Reference: Gurley et al. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases. AEM September 2018 Population: The Comparative Benchmarking System (CBS) database: a large database of malpractice claims covering more than 400 hospitals and more than 165,000 physicians. Intervention: Malpractice claims involving trainees (residents) in an emergency department setting over a three-year period from 2009-2012. Comparison: Malpractice claims not involving trainees in the same time period. Outcomes: Coded information covering a number of domains. Average Payment Case Severity (low, medium, high or death only) Allegation Category...
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Read MoreSGEM#228: Winds of Change – High Flow Nasal Oxygen for Acute Bronchiolitis?
Podcast Link: SGEM228 Date: September 5th, 2018 Reference: Franklin et al. A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. NEJM March 2018. Guest Skeptic: Dr. Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric emergency department. He is part of the Don’t Forget the Bubbles team. Case: Elsie is five months old and presents on day two of a bronchiolitic illness. She has taken just under half of her usual feeds so far today and has a respiratory rate of 58 breaths per minute and oxygen saturation of 90% on room air with moderate work of breathing. She is not clinically dehydrated and has a temp of 38.2C with clear rhinorrhea, red ears, a red throat and equal air entry with widespread crackles and wheeze. She was born at term, is immunised and has no significant medical history. Her parents Dave and Tony have driven 20 minutes from home to bring her to the regional hospital where you work. Your hospital has an inpatient paediatric ward but is a 90-minute drive from the nearest children’s hospital with PICU facilities. Background: We have covered bronchiolitis before on the SGEM#167 with expert Dr. Amy Plint. That episode looked at how bronchiolitis was managed in community hospitals. The bottom line was that there seemed to be a knowledge gap when it comes to managing bronchiolitis in the community setting (previous evidence as suggested a knowledge gap also exists in the academic pediatric hospitals). Although the vast majority of infants with bronchiolitis can be managed with supportive care at home, due to its high incidence, it is the number one reason for infants to be hospitalized (Njoo et al 2001, Langley et al 2003, Craig et al 2007 and Shay et al 1999). Since bronchiolitis is a clinical diagnosis, there is no test, including viral testing and radiography, which rules it in or out (Schuh et al 2007). Sadly, despite multiple guidelines (NICE, AAP, CPS), there has also been no “magic bullet” in terms of treatment. Hypertonic saline has been tried for acute bronchiolitis. A systematic review of this treatment modality was covered on SGEM#157. The bottom line at that time was that the data did not support the routine use of hypertonic saline for mild to moderate acute bronchiolitis. The American Academy of Pediatrics guideline says that oxygen therapy in infants with saturation of 90% or greater may not be needed...
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Read MoreSGEM#227: A Message to you Rudy – About Rudeness
Podcast Link: SGEM227 Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. Rudeness and Medical Team Performance. Pediatrics. February 2017 Guest Skeptic: Dr. Simon McCormick is an Emergency Medicine Consultant from Northern Ireland who works in Rotherham Hospital in Yorkshire, England. He is currently redeployed in Medical Education on “Burnout Sabbatical” but is hopeful of returning to the shop floor in the near future. He writes a blog called Broken Toy covering topics such as his experience with burnout, medical education and looking after each other. Case: You are working in the emergency department (ED) and have just been involved in a difficult case in the resuscitation room. During the resuscitation, a relative of the patient you have been treating named Rudy makes a derogatory/rude comment about Emergency Medicine (EM) staff. Background: Unfortunately, rudeness is a problem that is rife in medicine. It does not just come from patients and/or their relatives, as in this case, but can also come from the medical team. Specialties make fun of each other using unflattering stereotypes, seniors are unpleasant to juniors and physicians can say derogatory things to nurses. This internal rudeness has traditionally been seen as just “part of medicine”, a way to “build a tribe” or just part of the black humour and banter needed to survive in a tough environment. More recently, however, this has been questioned and people are now more inclined to think of the worst of this as a form of bullying and harassment and other, milder rudeness, as detrimental to the development of staff and harmful to a collaborative culture within medicine. Perhaps even more worryingly, is the concern that rudeness has an impact on staff performance, actually putting patients at risk. That said, it is unlikely that we can eradicate rudeness completely from our working lives. However, is it perhaps possible to reduce the impact rudeness may haveon staff, either with some form of pre-emptive education or a post event debriefing whether the rudeness comes from the team or those patients and families we are trying to help. Rudeness does not need to be part of medicine. A better option is to try kindness as outlined in the excellent book by Dr. Brian Goldman. We discussed Brian’s book on the SGEM Xtra called Don’t Give Up – The Power of Kindness. Being rude might make us feel better sometimes but that is always at the expense of who we are being rude to. Whilst it might take...
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Read MoreSGEM Xtra: The Top 10 Ch-ch-ch-changes to ATLS 10th Edition
Podcast Link: SGEM Xtra ATLS Date: August 25th, 2018 Guest Skeptic: Dr. Neil Parry is an Associate Professor of Surgery and Critical Care at Western University. He is the Medical Director of the Trauma Program for London Health Sciences Centre and the Site Chief of Surgery at Victoria Hospital. Dr. Parry is also a national member of the Committee on Trauma for the America College of Surgeons where he serves as a member of the ATLS Committee and as the Chair of the Surgical Skills Committee. This is an SGEM Xtra episode and will be the last show before staring Season #7 on September 1st. It has been an incredible ride. There are almost 37,000 subscribers to the SGEM. Our goal continues to be to cut the knowledge translation window down from over ten years to less than one year using the power of social media. Ultimately, we want patients to get the best care based on the best evidence. We also want to teach critical thinking skills and encourage skepticism. DISCLAIMER: These are Dr. Parry’s personal choices for the top 10 changes to ATLS and do not reflect the opinions of the ATLS committee, the Committee on Trauma of the American College of Surgeons, Western University or anyone else. Dr. Parry briefly tells the story of Dr. James K. Styner plane crash in 1976 that inspired him to start what became the Advanced Trauma and Life Support (ATLS) program. The ALTS program has been taught in 86 countries around the world and under gone a number of updates over last four decades. Here are the top 10 changes to ATLS 10th Edition according to Dr. Parry. You can listen to the SGEM podcast on iTunes to hear Neil expand on all the points listed below. Top 10 Changes to ATLS 10th Edition #1 – No More Lectures All interactive case – based discussions Students need to read manuals! True adult education – no spoon feeding #2 – New Skills Stations Case-based unfolding scenarios for A,B,C,D,E’s No longer anatomy based More student interaction #3 – “New/Honed” Skills for Instructors Must engage students Time management Five step method for skills teaching #4 – Shock One litre crystalloid and early administration of balanced blood products for Class III-IV shock Updated shock classification table to include blood products Introduce concept of damage control resuscitation #5 – Thoracic Trauma Needle decompression 4-5th intercostal space, anterior axillary line for adults...
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Read MoreSGEM#226: I Want A New Drug – One that Doesn’t Cause an Adverse Drug Event
Podcast Link: SGEM226 Date: August 16th, 2018 Reference: Hohl C et al. Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events. AEM Aug 2018. Guest Skeptic: Dr. Chris Bond 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: A 54-year-old female presents to the emergency department (ED) with abdominal pain and profuse non-bloody diarrhea for the past 24 hours. Her vital signs are within normal limits and she is tolerating oral fluids. There have been no recent suspicious meals or water sources, camping, spelunking, sick contacts and she does not have any birds or reptiles at home. She takes no regular medications; however, she did start amoxicillin/clavulanate (Clavulin or Augmentin) for a sinus infection three days ago. Background: Preventable adverse drug events (ADEs) are a common cause of ED visits, hospitalizations and death (Ref 1,2). ADEs cause or contribute to one in nine ED visits, and of deaths attributed to medical care, medications are the most common cause (Ref 3-6). Unfortunately, 20-50% of ADEs are not recognized by emergency and inpatient unit physicians (Refs 7-10). When ADEs are not recognized and corrected, inappropriate medication use continues, resulting in excess morbidity and health care resource utilization. Clinical pharmacists are trained to focus on medication management and are more likely to recognize medication-related ED presentations than physicians (Ref 11). However, clinical pharmacists are a scarce resource and not available in many centers. In centers where they are available, routine medication review in all patients presenting to the ED is not feasible. Evidence based criteria to enhance the identification and treatment of ADEs are needed to ensure high-risk patients are evaluated by clinical pharmacists and to improve their outcomes. Clinical Question: Can a clinical decision rule (tool) accurately identify patients presenting to the ED with adverse drug events? Reference: Hohl C et al. Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events. AEM Aug 2018. Population: Patients age 19 years and older presenting to the ED who reported using at least one prescription or over the counter medication in the two weeks prior. Exclusions: Non-English speaking and no translator with patient, violent behavior, intentional overdose, needlestick injury or sexual assault, previously...
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Read MoreSGEM#225: NEXUS II – Validation of the Pediatric Head CT Decision Instrument
Podcast Link: SGEM225 Date: July 16th, 2018 Reference: Gupta M et al. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. Her father was teaching her how to bike and he got a little ambitious and sent her down a small hill. She hit a rock, and went over the bars, striking her head on a small tree as she fell. She was helmeted, she did not lose consciousness, has not been vomiting, but the helmet was scratched up where it struck the tree. It’s been one hour since the accident and the child’s exam is otherwise normal; she’s behaving normally and only has a minor headache and some scrapes on her knees. Dad, on the other hand, may need something for anxiety. Background: Blunt head trauma is a common presenting complaint in emergency departments, accounting for approximately two million visits per year in the US. CT imaging is often performed but comes with radiation risks and increased medical costs. Several decision instruments have been developed to assess the risk of significant intracranial injury in children with head trauma (CATCH, CHALICE and PECARN). The PECARN tool has been found to have a high sensitivity, but in one study was shown to increase CT use compared to physician judgement. We covered concussions on SGEM#112. This episode included the pediatric head trauma CT decisions guide for children less than two years of age and those two years of age and older. The NEXUS Head CT decision instrument was developed as a “one way” instrument, which would hopefully serve to rule out those children who might otherwise receive imaging (as opposed to classifying many as “high risk”.) In the original cohort, use of NEXUS Head CT decision instrument decreased the need for CT by 25%. Clinical Question: In pediatric patients with blunt head trauma, can the NEXUS Head CT decision instrument be used to rule out the need for imaging in patients who otherwise would have received CT imaging? Reference: Gupta M et al. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. AEM July 2018...
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Read MoreSGEM Xtra: SGEM Season#4 Book
Podcast Link: Season#4 Book Date: July 13th, 2018 It’s summer time here in Canada and Season#6 of the SGEM is coming to an end. I hope SGEMers in the northern hemisphere are getting some time off for holidays with family and friend. There will still be new content uploaded over the summer. We have the monthly SGEM Hot Off the Press (SGEMHOP) episodes from Academic Emergency Medicine (AEM) scheduled for July and August. The SGEM continues to grow and has close to 36,000 subscribers. This knowledge translation (KT) project has been so successful because of supporters, guest skeptics and listeners like you. The goal of the SGEM continues to be to cut the KT window down from over ten years to less than one year. It does this by doing a structured critical review of a recent publication and then disseminates the information using the power of social media. We want patients to get the best care based on the best evidence. During July and August I will be getting ready for SGEM Season#7. We already have some great shows lined up with some familiar guest skeptics (Swami and Bob) and some new ones (Alison and Simon). Don’t panic…you will not go into withdrawal because here is SGEM Season#4 as a PDF book. There are links to all your favourite episodes. It is a way for me to thank you for all the support and encouragement over the last six years. Please feel free to share this 235 page book via your social media networks (email, Facebook, Twitter, Google+, etc). There have been five changes to the SGEM Season#4 PDF book version: New format with black background New fonts and graphics Chris Carpenter (Evidence Based Medicine Care) updated his chapter on evidence based medicine Justin Morgenstern (First10EM) has a simplified guide to approaching the literature Anthony Crocco (SketchyEBM) has a chapter on SketchyEBM where he encourages you to draw your own conclusions If you are looking for the inspiring theme music from each of the SGEM episodes you can now find them on Spotify. Of course most of them come from the 1980’s. Season#1 Season#2 Season#3 Season#4 This knowledge translation project continues to be part of the free open access to medical education movement (FOAMed). I continue to strongly believe we should share our intellectual capital and efforts with everyone around the world with no paywalls. This information should be for anyone, anywhere and at anytime. I also believe that patients deserve excellent care...
Most Recent Articles
SGEM#230: Tamsulosin – You’ve Lost that Loving Feeling – For Renal Colic
Podcast Link: SGEM230 Date: September 17th, 2018 Reference: Meltzer, A. et al. Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial. JAMA Internal Med, 2018. Guest Skeptics: Dr. Tony Seupaul, Professor and Chair, University of Arkansas for Medical Sciences Department of Emergency Medicine. Dr. Daniel Holleyman, Chief Resident at University of Arkansas for Medical Sciences Emergency Medicine Residency. Case: A 51-year-old man presents to the emergency department (ED) with five-hour history of acute onset left flank pain. The pain comes in waves, radiates into his left groin and is associated with nausea and vomiting. He noticed darkening of his urine, but does not have dysuria, fever, testicular pain, or penile discharge. You work him up and the urine analysis shows large blood, negative nitrites, negative bacteria. CT abdomen/pelvis without contrast is done which identifies a 7mm radiopaque stone in the left distal ureter. The patient receives 15mg ketorolac IV (SGEM#175) because you know there is a ceiling to the analgesic effect of non-steroidal anti-inflammatory drugs (NSAIDs). His pain improves significantly, and he is ready for discharge. He is given a referral to Urology for follow up of his ureteral stone, a prescription for oral antiemetics, and advised to take over-the-counter (OTC) NSAIDs. He asks if there is anything he could do or take to help the stone...
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SGEM#229: I Fought the Law and the Law Won – But Would it Matter if I had a Resident?
Podcast Link: SGEM229 Date: September 10th, 2018 Reference: Gurley et al. Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases. AEM September 2018 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the creator of the excellent #FOAMed project called First10EM.com Case: You are giving an introductory lecture on evidence-based medicine to the incoming class of residents, and after you finish you notice some excited chatter at the back of the room. Thinking that you have found some EBM keeners/gunners, you wander over to join the discussion, but find yourself in a heated discussion. One of the senior residents was recently named in a lawsuit, and the junior residents are worried. How likely are they to be sued? What can they do to prevent such a harrowing event? The residents turn to you, hoping that you can provide some insight on this topic. Background: Unfortunately, physicians are not perfect. Mistakes are made occasionally, and those mistakes can harm our patients. Medical care provided by trainees involves some added risks. In an internal medicine setting, problems with handoffs, teamwork, and lack of supervision were identified as issues in trainee malpractice cases. In Canada, we have a national organization called the Canadian Medical Protective Association (CMPA)....
Read More
SGEM#228: Winds of Change – High Flow Nasal Oxygen for Acute Bronchiolitis?
Podcast Link: SGEM228 Date: September 5th, 2018 Reference: Franklin et al. A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. NEJM March 2018. Guest Skeptic: Dr. Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric emergency department. He is part of the Don’t Forget the Bubbles team. Case: Elsie is five months old and presents on day two...
Read More
SGEM#227: A Message to you Rudy – About Rudeness
Podcast Link: SGEM227 Date: August 22nd, 2018 Reference: Riskin A, Erez A, Foulk TA, et al. Rudeness and Medical Team Performance. Pediatrics. February 2017 Guest Skeptic: Dr. Simon McCormick is an Emergency Medicine Consultant from Northern Ireland who works in Rotherham Hospital in Yorkshire, England. He is currently redeployed in Medical Education on “Burnout Sabbatical” but is hopeful of returning to the shop floor in the near future. He writes a blog called Broken Toy covering topics such as his experience with burnout, medical...
Read More
SGEM Xtra: The Top 10 Ch-ch-ch-changes to ATLS 10th Edition
Podcast Link: SGEM Xtra ATLS Date: August 25th, 2018 Guest Skeptic: Dr. Neil Parry is an Associate Professor of Surgery and Critical Care at Western University. He is the Medical Director of the Trauma Program for London Health Sciences Centre and the Site Chief of Surgery at Victoria Hospital. Dr. Parry is also a national member of the Committee on Trauma for the America College of Surgeons where he serves as a member of the ATLS Committee and as the Chair of the Surgical...
Read More
SGEM#226: I Want A New Drug – One that Doesn’t Cause an Adverse Drug Event
Podcast Link: SGEM226 Date: August 16th, 2018 Reference: Hohl C et al. Prospective Validation of Clinical Criteria to Identify Emergency Department Patients at High Risk for Adverse Drug Events. AEM Aug 2018. Guest Skeptic: Dr. Chris Bond 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...
Read More
SGEM#225: NEXUS II – Validation of the Pediatric Head CT Decision Instrument
Podcast Link: SGEM225 Date: July 16th, 2018 Reference: Gupta M et al. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. Her father was teaching...
Read More
SGEM Xtra: SGEM Season#4 Book
Podcast Link: Season#4 Book Date: July 13th, 2018 It’s summer time here in Canada and Season#6 of the SGEM is coming to an end. I hope SGEMers in the northern hemisphere are getting some time off for holidays with family and friend. There will still be new content uploaded over the summer. We have the monthly SGEM Hot Off the Press (SGEMHOP) episodes from Academic Emergency Medicine (AEM) scheduled for July and August. The SGEM continues to grow and has close...
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SGEM#224: Battlefield Acupuncture – Don’t Do Me Like That
Podcast Link: SGEM224 BFA Date: June 20th, 2018 Reference: Fox LM et al. Battlefield acupuncture to treat low back pain in the emergency department. Am J EM 2018 Guest Skeptics: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s seventh visit to the SGEM, and his first since returning from deployment. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force. Case: A 48-year-old male presents to...
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SGEM#223: Haven’t Got Time for the Pain – What about IV Lidocaine?
Podcast Link: SGEM223 Date: June 15th, 2018 Reference: Silva et al. Safety and Efficacy of Intravenous Lidocaine for Pain Management in the Emergency Department: A Systematic Review. Ann Emerg Med. 2018 Guest Skeptics: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical Center in New York City. Lucas Silva is a 5th year medical student from Brazil (6-years program in Latin America) and a former Research Fellow in the Department of Emergency Medicine at the Mayo Clinic...
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SGEM#222: Rhythm is Gonna Get You – Into an Atrial Fibrillation Pathway
Podcast Link: SGEM222 Date: June 12th, 2018 Reference: DeMeester S et al. Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the creator of the excellent #FOAMed project called First10EM.com and an amazing photographer. Case: A 62-year-old Canadian is on vacation in up-state Michigan, and after a celebratory...
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SGEM#221: Smells Like Isopropyl Alcohol for Nausea
Podcast Link: SGEM221 Date: June 8th, 2018 Reference: April MD, et al. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. Ann Emerg Med 2018 Guest Skeptic: Meghan Groth is a pharmacist who has been practicing in emergency medicine for the past six years. She’s recently transitioned into industry, taking on a position as a medical science liaison in New England. She’s been a contributor for the Academic Life in Emergency Medicine and Emergency Medicine PharmD...
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