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SGEM#198: Better Slow Down – Push vs. Short Infusion of Low Dose Ketamine for Pain in the Emergency Department

Posted by on Dec 9, 2017 in Featured, Pharmacology/Toxicology, Podcasts | 1 comment

Podcast Link: SGEM198 Date: November 28th, 2017 Reference: Motov S et al. A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department. AJEM 2017. Guest Skeptic: Dr. 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. Case: A 54-year old female patient with acute back pain comes to your emergency department for her forth visit in seven days for recurring pain.  She was lifting something heavy and felt a“pop” in her back.  She denies bowel or bladder issues, saddle paresthesia, lower extremity weakness, but does feel radicular pain down both of her legs.  She has been given intravenous hydromorphone, diazepam, and ketorolac without relief of her symptoms.  You decide to give her low dose ketamine, as this has worked in the past. Background: Low back pain is a common and challenging presentation to the emergency department. While the vast majority of presentations are benign, these cases can be time consuming and frustrating for both patients and physicians. Physician frustrations with managing acute non-traumatic low back pain include considering rare dangerous back pain patient (epidural abscesses, osteomyelitis, pathological fractures, etc),...

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SGEM#197: Die Trying – Intubation of In-Hospital Cardiac Arrests

Posted by on Dec 3, 2017 in Cardiac, Featured, Podcasts | 8 comments

Podcast Link: SGEM197 Date: November 24th, 2017 Reference: Andersen et al. Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival. JAMA 2017 Guest Skeptic: Dr. Bob Edmonds is an Emergency Physician in the US Air Force.  He is currently deployed, practicing emergency medicine in an undisclosed location. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force. Case: You are working a regular shift in the emergency department when you hear a code blue called. You are the first physician to respond and you begin to resuscitate the patient. Your respiratory therapist is adequately ventilating the patient with a bag valve mask, and they ask you if they should prepare to intubate at the pulse and rhythm check. Background: We have talked about out-of-hospital cardiac arrests (OHCA) many times on the SGEM. SGEM#64: Classic EM Papers (OPALS Study) SGEM#136: CPR – Man or Machine? SGEM#143: Call Me Maybe for Bystander CPR SGEM#152: Movin’ on Up – Higher Floors, Lower Survival for OHCA SGEM#162: Not Stayin’ Alive More Often with Amiodarone or Lidocaine in OHCA SGEM#189: Bring Me To Life in OHCA This time, as the case identifies, we are going to be talking about in-hospital cardiac arrests (IHCA) today. The American Heart Association (AHA) reports...

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SGEM#196: Gastroparesis – I Feel Like Throwing Up

Posted by on Nov 26, 2017 in Featured, GastroIntestinal, Podcasts | 13 comments

Podcast Link: SGEM196 Date: November 24th, 2017 Reference: Roldan et al. Trial Comparing Haloperidol Combined With Conventional Therapy to Conventional Therapy Alone in Patients With Symptomatic Gastroparesis. AEM November 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 creator of the excellent #FOAMed project called First10EM.com Case: You charge nurse approaches as you finish charting on the trauma patient who was just transferred out. “Mrs. G. is...

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SGEM#195: Some Like It Hot – ED Temperature and ICU Survival

Posted by on Nov 19, 2017 in Featured, Infectious, Podcasts | 3 comments

Podcast Link: SGEM195 Date: November 11th, 2017 Reference: Sundén-Cullberg et al. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Critical Care Medicine 2017. Guest Skeptic: Jesse Spurr works as a Nurse Educator in the Emergency Department at Redcliffe Hospital in Australia. Outside his family and work, Jesse pours energy into his professional hobbies: healthcare simulation podcast Simulcast, nursing practice development blog and podcast Injectable Orange and faculty and team member of The...

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SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations

Posted by on Nov 12, 2017 in Featured, Pediatrics, Podcasts | 9 comments

Podcast Link: SGEM194 Date: November 9th, 2017 Reference: Cronin JJ et al. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department. Ann Emerg Med 2016 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine provider who works at Harlem Hospital Center in New York and Children’s National Medical Center in Washington, DC.  He was Director of Emergency Department Simulation and the Co-Fellowship Director at ST Luke’s-Roosevelt Hospital in New...

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SGEM Xtra: Western University Resident Teaching Boot Camp

Posted by on Nov 8, 2017 in Podcasts | 5 comments

Date: November 8th, 2017 I had the pleasure of demonstrating how to teach evidence-based medicine yesterday to Western University residents. It was part of a Boot Camp put on by the Schulich School of Medicine and Dentistry. It is an annual event designed to teach residents how to be better teachers. The conference is officially called Boot Camp for Resident Teachers. Program Directors nominate exemplary residents with an interest in teaching. It is described as “an intensive 2-day program focusing on...

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SGEM#193: Stop, In the Name of Love

Posted by on Oct 29, 2017 in Featured, Pediatrics, Podcasts | 4 comments

Podcast Link: SGEM193 Date: October 24th, 2017 Reference: Harrison et al. Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis. Pediatrics 2017 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. Anthony is also the creator of SketchyEBM. Case: A 12-day old girl presents with fever and is otherwise well. You are planning to begin a full septic workup including some painful...

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SGEM Xtra: Dr. Jennifer Gunter – Super Hero of Science

Posted by on Oct 27, 2017 in Featured, Gynecologic, Podcasts | 3 comments

Podcast: SGEM Xtra Dr. Jen Gunter Date: October 20th, 2017 Dr. Jen Gunter is an gynaecologist from Canada who practices in San Fransisco. She writes a blog discussing women’s health issues and debunking pseudoscience. She is known to wield the lasso of truth, just like Wonder Woman. Jen became an internet sensation recently after challenging Gwyneth Paltrow and her lifestyle company GOOP over some of their products. This included vaginal steaming and jade eggs. Jen’s blog posts got a lot of...

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SGEM#192: Sometimes, All You Need is the Air that You Breathe

Posted by on Oct 22, 2017 in Cardiac, Featured, Podcasts | 6 comments

Podcast Link: SGEM192 Date: October 19th, 2017 Reference: Hofmann et al. Oxygen Therapy in Suspected Acute Myocardial Infarction. NEJM Sept 2017. Guest Skeptic: Marcus Prescott is a nurse in Norway. He is also now a first-year medical student. Case: A 68-year-old man with a history of hypertension and dyslipidemia develops chest pain while grocery shopping. Emergency medical services are called, arrive quickly and find a man with 7/10 chest pain. His vitals are: heart rate of 72 beats per minute, blood...

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SGEM Xtra: ASMUQ Scientific Conference

Posted by on Oct 18, 2017 in Conferences, Featured, Podcasts | 0 comments

Date: October 18th, 2017 Thank you to the organizing committee for inviting me to Montreal to present at the ASMUQ annual conference. It was wonderful to see existing friends and make a few new friends. The first talk was called The Medical Myth Menace.  It addressed six emergency medicine myths by reviewing six recent publications. For each myth some background information was provided, a specific clinical question was asked, the P.I.C.O. (population, intervention, control/comparison, outcome) was reviewed, key results given, the bottom line stated and...

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SGEM Xtra: SEMAC IX

Posted by on Oct 15, 2017 in Conferences, Featured, Podcasts | 0 comments

Date: October 15th, 2017 I had the privilege to present a plenary talk at the Saskatchewan Emergency Medicine Annual Conference (SEMAC). It was held in the majestic Delta Hotel in Saskatoon. Thank you to Dr. James Stempien, Dr. Paul Olszynski and the organizing committee for inviting me and showing me such hospitality.   The plenary talk was entitled Going On-Line to Meet your Continuing Medical Education (CME) Needs. It tried to answer why we need to go on-line and how to go on-line. Why...

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SGEM#191: No Time for Physio – Roll With It

Posted by on Oct 8, 2017 in Featured, Musculoskeletal, Podcasts | 2 comments

 Podcast Link: SGEM191 Date: October 5th, 2017 Reference: Brison et al. Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial. BMJ Nov 2016. Guest Skeptic: Dr. Steve Joseph. Steve completed his Sport Medicine fellowship training with the Fowler Kennedy Sport Medicine Clinic in 2017. He served with the Canadian Forces as a Medical Officer and Flight Surgeon. Steve is currently an Assistant Professor in the Department of Family Medicine at Western University working at the Fowler...

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