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SGEM#172: Don’t Bring My Blood Pressure Down (Intensively) – The ATACH2 Trial

Posted by on Mar 26, 2017 in Featured, Hematologic, Neurologic, Podcasts | 1 comment

Podcast Link: SGEM172 Date: March 21st, 2017 Reference: Qureshi et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. NEJM June 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 hosts a blog and podcast called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. Although Chip’s focus is to educate those working in rural and remote settings, his goal has been to help others provide total care everywhere. Case: A 68 year-old female arrives via EMS for left sided weakness starting two hours prior to arrival in the emergency department. She does not take blood thinners and has lived independently prior to her complaint today. Her head CT without contrast demonstrates a bleed of the right parietal region that measures 52cm3 in size. On arrival her blood pressure is 220/140, which was also found by EMS. The patient’s nurse asks you what blood pressure target you want to aim for given her bleed. Background: Bleeding in the brain can be bad and can result in morbidity and mortality. There is limited data about the target for systolic blood pressure when treating acute hypertensive response in patients with...

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SGEM#171: Step-by-Step Approach to the Febrile Infant

Posted by on Mar 12, 2017 in Featured, Infectious, Pediatrics, Podcasts | 6 comments

Podcast Link: SGEM171 Date: February 27th, 2017 Reference: Gomez et al. Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Pediatrics 2016. Guest Skeptic: Dr. Anthony Crocco is a Pediatric Emergency Physician and is the Medical Director & Division Head of the Division of Pediatric Emergency at McMaster’s Children’s Hospital. He is also the creator of SketchyEBM. Case: A 25-day-old girl presents with fever. There is no history of congestion, cough, vomiting, diarrhea, shortness of breath or any other focus for her infection. She looks well on exam and her vitals are normal except for a rectal temperature of 38.3C. She is less than 28 days old and you wonder how much of a work up to do (full septic workup, intravenous antibioticsadmission to hospital, blood and urine tests)? Background: Fever without source in infants less than three months old represents a significant diagnostic dilemma for clinicians. Several criteria had been developed previously, including the Rochester (Jaskiewicz et al 1994), Boston (Baskin et al 1992) and Philadelphia (Baker et al 1993) criteria to help clinicians stratify the risk of significant bacterial infections. These criteria, however, are out-dated in our current era of vaccinations, but to date, have represented our best option. A new algorithm has been developed by a European group of pediatric emergency physicians called...

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SGEM#170: Don’t Go Breaking My Heart – Ottawa Heart Failure Risk Scale

Posted by on Mar 5, 2017 in Cardiac, Featured, Podcasts | 26 comments

Podcast Link: SGEM170 Date: March 2nd, 2017 Reference: Stiell et al. Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. AEM March 2017 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the author of the excellent #FOAMed blog called First10EM.com and is an associate editor of Emergency Medicine Cases. Case: A 68-year-old woman with a history...

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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...

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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...

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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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