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SGEM#233: Larry in the Den with Kiwis (LDK) – Low Dose Ketamine vs. Opioids for Acute Pain

Posted by on Oct 13, 2018 in Featured, Podcasts | 0 comments

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...

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SGEM#232: I Can See Clearly Now the Collar is Gone – Thanks to the Triage Nurse

Posted by on Oct 6, 2018 in Musculoskeletal, Neurologic, Podcasts, Trauma | 0 comments

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...

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SGEM#231: You’re So Vein – IO vs. IV Access for OHCA

Posted by on Sep 29, 2018 in Cardiac, Featured, Podcasts | 0 comments

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...

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SGEM#230: Tamsulosin – You’ve Lost that Loving Feeling – For Renal Colic

Posted by on Sep 22, 2018 in Featured, Genitourinary, Podcasts | 0 comments

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...

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SGEM#229: I Fought the Law and the Law Won – But Would it Matter if I had a Resident?

Posted by on Sep 15, 2018 in Featured, Podcasts | 0 comments

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...

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SGEM#228: Winds of Change – High Flow Nasal Oxygen for Acute Bronchiolitis?

Posted by on Sep 8, 2018 in Featured, Infectious, Pediatrics, Podcasts | 0 comments

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...

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SGEM#227: A Message to you Rudy – About Rudeness

Posted by on Sep 1, 2018 in Featured, Podcasts, Psychiatric | 0 comments

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...

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SGEM Xtra: The Top 10 Ch-ch-ch-changes to ATLS 10th Edition

Posted by on Aug 26, 2018 in Featured, Podcasts, Trauma | 0 comments

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

Posted by on Aug 18, 2018 in Featured, Pharmacology/Toxicology, Podcasts | 0 comments

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

Posted by on Jul 17, 2018 in Featured, Neurologic, Pediatrics, Podcasts, Trauma | 0 comments

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

Posted by on Jul 13, 2018 in Featured, Podcasts | 0 comments

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

Posted by on Jun 30, 2018 in Featured, Musculoskeletal, Podcasts | 0 comments

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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