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Read MoreSGEM#233: Larry in the Den with Kiwis (LDK) – Low Dose Ketamine vs. Opioids for Acute Pain
Podcast Link: SGEM233 Date: October 10th , 2018 Reference: Karlow et al. A Systematic Review And Meta-Analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. AEM Oct 2018. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME Editor for Academic Emergency Medicine. Case: You are caring for a 38-year-old male (Larry) who presented to the emergency department with lower back pain. During your evaluation, he tells you he doesn’t want any narcotic pain medication. You wonder if there are alternative options, and a colleague reminds you that ketamine has recently gained a lot of exposure as a possible alternative. Background: The amelioration of pain and suffering should be one of the top priorities of emergency physicians. In 2001, JACHO made pain the 5th vital sign to address the issue of oligoanalgesia, which unfortunately created many problems. Opiates became a very common treatment for acute pain in the ED setting after JACHO and the introduction of new and powerful opioids like oxycodone. However, in recent years, an increased desire for alternatives has been prompted in an attempt to reduce opiate usage. The pendulum is swinging to opiophobia. This can leave the patient left in the middle with ineffective pain management. One alternative or adjunct to limit the use of opioids in the ED is low dose ketamine (LDK). Several studies have been performed evaluating low dose ketamine (LDK) for acute pain, with a variety of methodological designs, time endpoints, and doses. We have covered some of those papers and watched the literature develop over the years on the SGEM. SGEM#111: Comfortably Numb – Low dose Ketamine as Adjunct for ED Pain Control SGEM Bottom Line: High-quality published evidence to support the use of sub dissociative-dose ketamine to quickly reduce acute pain in emergency department settings is lacking, but lower quality studies inconsistently demonstrate effectiveness with uniformly low risk of adverse effects. SGEM#130: Low Dose Ketamine for Acute Pain Control in the Emergency Department (reviewed two ketamine papers) SGEM Bottom Line: For patients who have a contraindication to opioids such as allergy or hypotension, sub dissociative ketamine would be a reasonable option to consider for treating acute pain. SGEM Bottom Line: While further validation in other settings is needed, this study suggests ketamine as a relatively safe option for patients who do not achieve analgesia with high doses of morphine or are unable to tolerate them. SGEM#198: Better Slow Down – Push vs. Short Infusion...
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Read MoreSGEM#232: I Can See Clearly Now the Collar is Gone – Thanks to the Triage Nurse
Podcast Link: SGEM232 Date: October 5th , 2018 Reference: Stiell et al. A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. Case: There are two case scenarios this week to try and capture the two common ways patients present to the triage nurse. Case 1: A 51-year-old male patient presents to triage in a collar on a back-board via EMS following a rear-end motor vehicle collision (MVC) at a stop light. He was a belted driver with no past medical history and GCS 15. The driver of the car that hit him was texting and did not appear to slow before striking the rear of the patient’s car at about 50 km/hr. The patient complains of left shoulder and neck pain. Case 2: A 45-year-old female presents to triage at 20:30 walking stating that she fell from a chair this morning. She went to work all day as she thought she was unhurt initially, but pain has started to set in so she stopped by the emergency department on the way home complaining of right wrist and neck pain and stiffness all over. She is worried she may have a serious injury to her neck. Background: Clearing the c-spines is a regular activity in the emergency department (ED). This can be done clinically using the Canadian C-Spine Rules/Tools or with imaging. The vast majority of these patients (>99%) do not have a fractured cervical spine diagnosed. Blunt trauma patients transported via EMS often arrive on a backboard, c-collar and head restraints. They remain this way often complaining to the nurse until they can be assessed by a physician and have their c-spine cleared. There are protocols to get blunt trauma patients off spine boards urgently. However, they still can remain in c-spine precautions for a long time waiting to be assessed. This adds to patient discomfort, occupies valuable acute ED space and can contribute to crowding. The Canadian C-Spine Rule (CCR) is a clinical decision instrument developed to allow clinicians to clear the c-spine without imaging (1). This instrument has been validated to be safe and decrease use of diagnostic imaging (2,3). Canadian C-Spine Rule (CCR) The CCR applies to alert (GCS=15) and stable trauma patients where cervical spine injury is a concern Dangerous Mechanism Fall from elevation>=3 feet/ 5 stairs Axial load to...
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Read MoreSGEM#231: You’re So Vein – IO vs. IV Access for OHCA
Podcast Link: SGEM231 Date: September 21st, 2018 Reference: Kawano et al. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound. Case: A 46-year-old man has a cardiac arrest at home, witnessed by family. Bystander CPR is initiated prior to EMS arrival. EMS arrives on scene and initiates high quality basic life support (BLS). One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF. As part of their protocol, they attempt vascular access to administer epinephrine and an antidysrhythmic. They wonder whether it would be better to attempt a peripheral intravenous (IV) line or intraosseous access first? Background: Cardiac arrest care has evolved drastically over the past couple of decades, but not in the way many may have expected. We now know that an emphasis on the basics (high quality chest compressions and defibrillation) are the most important aspects of resuscitation. More advanced skills such as airway management, vascular access, and cardiac medications are being de-emphasized. It was the classic OPALS paper covered on SGEM#64 by the Legend of Emergency Medicine Dr. Ian Stiell that demonstrated no advantage to ACLS vs. BLS for out-of-hospital cardiac arrest (OHCA). There have been other SGEM episodes that question the efficacy of various interventions: Man vs. mechanical CPR for OHCA (SGEM#136) ACLS for OHCA (SGEM#189) Not Stayin’ Alive More Often with Amiodarone or Lidocaine (SGEM#162) Remote ischemic conditioning for OHCA (SGEM#116) Pre-hospital therapeutic hypothermia (SGEM#21, SGEM#54, SGEM#82 and SGEM#183) The resuscitation science community has been struggling to find advanced interventions that can show a benefit in mortality and, most importantly survival with good neurological outcome. Intraosseous access has become a mainstay of cardiac arrest care due to its speed and reliability. However, no randomized trial has compared intravenous access to intraosseous access with a primary outcome of good neurologic function. Clinical Question: Is intraosseous vascular access in the pre-hospital setting for OHCA associated with better neurologic outcomes compared to intravenous vascular access? Reference: Kawano et al.Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Annals of EM May 2018 Population: Out-of-hospital, non-traumatic, adult cardiac arrest patients Excluded: Unsuccessful attempt or more than one access site. Patients were also excluded if incarcerated or pregnant,...
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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...
Most Recent Articles
SGEM#233: Larry in the Den with Kiwis (LDK) – Low Dose Ketamine vs. Opioids for Acute Pain
Podcast Link: SGEM233 Date: October 10th , 2018 Reference: Karlow et al. A Systematic Review And Meta-Analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. AEM Oct 2018. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME Editor for Academic Emergency Medicine. Case: You are caring for a 38-year-old male (Larry) who presented to the emergency department with lower back pain. During your evaluation, he tells you he doesn’t want any narcotic pain medication. You wonder if there are alternative options, and a colleague reminds you that ketamine has recently gained a lot of exposure as a possible alternative. Background: The amelioration of pain and suffering should be one of the top priorities of emergency physicians. In 2001, JACHO made pain the 5th vital sign to address the issue of oligoanalgesia, which unfortunately created many problems. Opiates became a very common treatment for acute pain in the ED setting after JACHO and the introduction of new and powerful opioids like oxycodone. However, in recent years, an increased desire for alternatives has been prompted in an attempt to reduce opiate usage. The pendulum is swinging to opiophobia. This can leave the patient left in the middle with ineffective pain management. One alternative or adjunct to limit...
Read More
SGEM#232: I Can See Clearly Now the Collar is Gone – Thanks to the Triage Nurse
Podcast Link: SGEM232 Date: October 5th , 2018 Reference: Stiell et al. A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. Case: There are two case scenarios this week to try and capture the two common ways patients present to the triage nurse. Case 1: A 51-year-old male patient presents to triage in a collar on a back-board via EMS following a rear-end motor vehicle collision (MVC) at a stop light. He was a belted driver with no past medical history and GCS 15. The driver of the car that hit him was texting and did not appear to slow before striking the rear of the patient’s car at about 50 km/hr. The patient complains of left shoulder and neck pain. Case 2: A 45-year-old female presents to triage at 20:30 walking stating that she fell from a chair this morning. She went to work all day as she thought she was unhurt initially, but pain has started to set in so she stopped by the emergency department on the way home complaining of right wrist and neck pain and stiffness all over. She is worried she may...
Read More
SGEM#231: You’re So Vein – IO vs. IV Access for OHCA
Podcast Link: SGEM231 Date: September 21st, 2018 Reference: Kawano et al. Intraosseous Vascular Access Is Associated With Lower Survival and Neurologic Recovery Among Patients With Out-of-Hospital Cardiac Arrest. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, prehospital critical care, airway management, and point-of-care ultrasound. Case: A 46-year-old man has a cardiac arrest at home, witnessed by family. Bystander CPR is initiated...
Read More
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...
Read More
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...
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...
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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...
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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...
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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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