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SGEM#138: Hip to be Blocked – Regional Nerve Blocks for Hip and Femoral Neck Fractures

Posted by on Nov 29, 2015 in Featured, Musculoskeletal, Podcasts | 0 comments

Podcast Link: SGEM138 Date: November 29th, 2015 Guest Skeptics: Dr. Brandon Ritcey is an Emergency Medicine Resident from the University of Ottawa. Dr. Chris Bond is an Emergency Medicine physician and clinical lecturer at the University of Calgary. His interests include knowledge translation, FOAMed, and all things food and wine related. Chris has a blog called SOCMOB and is the new host of CAEP Cast. This is another SGEM Hot Off the Press (#SGEMHOP). The goal of the #SGEMHOP is to cut the knowledge translation window down from over ten years to less than one month. This time the paper is from the Canadian Journal of Emergency Medicine (CJEM). We look forward to hearing your feedback via Twitter, Facebook and on the SGEM blog. Case: A 75-year-old woman has a ground level fall in her apartment. She is brought to the emergency department with an isolated hip injury. She has a past medical history of high blood pressure and gastroesophageal reflex disease. Her only complaint is hip pain. On exam her vital signs are normal. The only abnormality found is a shortened and externally rotated left leg. An x-ray demonstrates a femoral neck fracture. The nurse wants to know what you want to give her for pain. Background: Oligoanalgesia is a well-recognized problem in the emergency department (Wilson...

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SGEM#137: A Foggy Day – Endovascular Treatment for Acute Ischemic Stroke

Posted by on Nov 22, 2015 in Featured, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM137 Date: November 21st, 2015 Guest Skeptic: Dr. Rory Spiegel is an Emergency Medicine resident in New York City. Rory is doing a resuscitation fellowship at Stony Brook University School of Medicine. He also writes a blog called EM Nerd about nihilism, medicine and the art of doing nothing. Case: An 78-year-old woman presents to your emergency department with right arm weakness and slurred speech for the last two hours.  She has a history of hypertension and diabetes. A CTA is performed that shows an Intracranial arterial occlusion of the right M1 middle cerebral artery segment. Background: Prior to the publication of MR CLEAN and the four trials published in its wake, the data regarding endovascular therapy has been consistently negative. Over the past year five RCTs examining endovascular therapy for acute ischemic stroke have been published. In direct contrast to the three trials published in 2013, all of the recent trials were impressively positive. Because of methodological flaws, the true size of benefit these interventions provide is still unclear. Without an understanding of this effect size, it is difficult to assess whether this benefit justifies the resources required to support its implementation on a national level. Clinical Question: Do endovascular therapies for acute ischemic stroke lead to improved neurological outcomes when compared to medical therapies...

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SGEM#136: CPR – Man or Machine?

Posted by on Nov 16, 2015 in Cardiac, Featured, Podcasts | 3 comments

Podcast Link: SGEM136 Date: November 13th, 2015 Guest Skeptic: Dr. Salim Rezaie. Salim is an associate clinical professor of Emergency Medicine/Internal Medicine at the University of Texas Health Science Center at San Antonio, Texas. He is the creator/founder of the REBEL EM Blog and REBEL Cast. Case: A 65-year old male has a witnessed cardiac arrest. He receives immediate CPR, early defibrillation, as well as one round of ACLS medications. He arrives via EMS to your emergency department, where they tell...

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SGEM#135: The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen

Posted by on Nov 8, 2015 in Cardiac, Featured, Podcasts, Pulmonary | 1 comment

Podcast Link: SGEM135 Date: October 28th, 2015 Guest Skeptic: Dr. Justin Morgenstern. Justin is an emergency physician and the director of simulation education at Markham Stouffville Hospital in Ontario. He loves skepticism and medical education, especially when it is free and open access. He is the author of the #FOAMed blog and is an associate editor of Emergency Medicine Cases. Case: A 60-year-old male with no major past medical history presents to your community emergency department with a three-day history...

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SGEM#134: Listen, to what the British Doctors Say about LPs post CT for SAH

Posted by on Nov 1, 2015 in Featured, Neurologic, Podcasts | 19 comments

Podcast Link: SGEM134 Date: October 27th, 2015 Guest Skeptic: Dr. David Sayer is a physician completing his general practice training in the United Kingdom. Case Scenario: A 34-year-old woman presents with acute onset of headache peaking in 30 minutes with no recent trauma, focal deficits and a normal neurologic examination. Background: Headaches represent around 2% of all emergency department visits. Of these presentations 1-3% turn out to be a subarachnoid hemorrhage (SAH)  (Edlow, Vermeulen, Perry, Morgenstern). About 5% of SAH are misdiagnosed on the first...

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SGEM Xtra: The Reality Check

Posted by on Oct 26, 2015 in Featured | 0 comments

I had the pleasure of being a guest panelist on The Reality Check (TRC) podcast this week. TRC is “Canada’s weekly podcast that explores a wide range of controversies and curiosities using science and critical thinking.” They invited me on to discuss some of my favourite things like evidence based medicine, knowledge translation and FOAMed. Listen to the show by clicking on this link to the MP3 file or subscribing to TRC on iTunes. We had lots of fun discussing...

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SGEM#133: Just Beat It (Atrial Fibrillation) with Diltiazem or Metoprolol?

Posted by on Oct 25, 2015 in Cardiac, Featured, Podcasts | 4 comments

Podcast Link: SGEM133 Date: October 23rd, 2015 Guest Skeptic: Dr. Anand Swaninathan is an assistant program director at NYU/Bellevue Hospital in the Department of Emergency Medicine. He is also part of REBEL EM, The Teaching Course, Emergency Medical Abstracts and a new FOAM site – Core EM. Case: A 53 year-old woman with no past medical history presents to the emergency department with palpitations for four days. She says she has felt fatigued and a bit short of breath. Vitals reveal...

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SGEM#132: One Balloon for Otitis Media with Effusion

Posted by on Oct 19, 2015 in Featured, Pediatrics, Podcasts | 2 comments

Podcast Link: SGEM132 Date: October 15th, 2015 Guest Skeptic: Dr. Richard Lubell is a community pediatrician in London, Ontario with over 30 years of experience. He is an associate professor in the Department of Pediatrics at Western University. Case: A four-year-old boy presents to the emergency department after being picked up from school. The mother is worried he has another ear infection. This is because the teacher thought he was having trouble hearing in class. The child completed a course...

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SGEM#131: Gimme Some Antibiotics for Uncomplicated Skin Infections

Posted by on Oct 11, 2015 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM131 Date: October 8th, 2015 Case: A 26-year-old male presents to your emergency department with complaints of a painful, reddened area on his right arm. He has no significant past medical history, surgical history, or social history, but reports that he has an allergic reaction to penicillin and cephalosporin antibiotics. On exam, you find an abscess approximately 6cm in diameter with surrounding cellulitis. After performing an incision and drainage, you contemplate sending the patient home with a prescription...

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SGEM#130: Low Dose Ketamine for Acute Pain Control in the Emergency Department

Posted by on Oct 4, 2015 in Featured, Musculoskeletal, Podcasts | 8 comments

Podcast Link: SGEM130 Date: September 22nd, 2015 Guest Skeptics: Dr. Marcel Emond. Marcel is an Associate professor, Laval University. Emergency physician the level one trauma centre in Quebec City. Research Director of the Canadian Emergency Team Initiative (CETI). Marcel is also the lead for SGEM Global French. If you are interested in evidence based medicine, shortening the KT window down to less than one year, speak another language and always wanted to podcast then contact me at with global in the subject...

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SGEM#129: That Chest Tube…She’s a Beauty

Posted by on Sep 27, 2015 in Featured, Podcasts, Pulmonary, Trauma | 4 comments

Podcast Link: SGEM129 Date: August 14th, 2015 Guest Skeptics: Dr. Rick Malthaner is the Director of Thoracic Surgery Research, Professor of Surgery, Epidemiology and Biostatistics at the Schulich School of Medicine and Dentistry, Western University, Canada. Case: A 25 year old female was allegedly stabbed while standing on the corner minding her own business. She was found unconscious (Glasgow Coma Scale 7) and was intubated by the EMS. On arrival in your emergency department, the vitals are stable, but there is decreased...

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SGEM#128: One Hour AMI Rule Out/Rule In (Harder, Better, Faster?)

Posted by on Sep 20, 2015 in Cardiac, Featured, Podcasts | 0 comments

Podcast Link: SGEM128 Date: September 10th, 2015 Guest Skeptic: Daniel McCollum. Daniel is an Assistant Residency Director at Georgia Regents University in beautiful Augusta, GA. He loves craft beer, evidence based medicine, and Batman.  Case: A 53 year-old man presents with left sided chest pain that started 90 minutes ago. The pain radiates to his left arm and he has nausea without vomiting. The pain began while he was doing yard work and he has never had pain like this...

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