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Read MoreSGEM Xtra: Diane Birnbaumer – Legend of Emergency Medicine
Podcast Link: SGEM Xtra Diane Birnbaumer Date: May 12th, 2017 Guest Skeptic: Dr. Diane Birnbaumer is a Senior Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is also an Emeritus Professor of Medicine at the David Geffen School of Medicine at UCLA. Diane will be a keynote speaker at FeminEM conference in New York City this October called FIX2017. Legends of Emergency Medicine: This is the second episode in the summer series of SGEM Xtras called Legends of Emergency Medicine. These episodes highlight some of the pioneers and leaders of our specialty. I hope these episodes will give the next generation of emergency physicians access to some super stars in our field via social media. The format of the show will be similar. We will start by finding out some a non-medical thing about the legend: What song they picked as their music for the episode and why? Then we will tell the back story of how we first met. The more formal part of the episode asks the legend five questions. Listen to the podcast on iTunes to hear their responses. Five Questions for Diane: What is the biggest positive change you have seen in emergency medicine over your career? What is the biggest negative change you have seen in emergency medicine over your career? What contribution to emergency medicine that you made are you most proud of so far? What advice would you give to someone who is interested going into emergency medicine? How do you picture emergency medicine looking in the next ten years? Theme Music: Each legend was asked to pick theme music for their episode and explain why they picked that particular song. Diane picked Brick House by the Commodores. I hope you enjoy this summer SGEM Xtra series of podcasts. Don’t Panic – The SGEM will be back in the fall for Season#6. You can expect more critical appraisals of recent publications trying to cut the knowledge translation window down from over ten years to less than one year using the power of social media. The ultimate goal of the SGEM is for patients to get the best care based on the best evidence. Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency medicine. SGEM Xtra: Diane Birnbaumer - Legend of Emergency Medicine Play Now | Play in Popup |...
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Read MoreSGEM#185: Every EHR Wants to “Rule” the World
Podcast Link: SGEM185 Date: July 11th, 2017 Reference: Bookman K et al. Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High-cost Imaging in the Emergency Department: EmbED study. AEM July 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 are working a very busy shift in the emergency department. Your first patient was involved in an motor vehicle collision (MVC), and you pulled up the app to review the Canadian CT Head Injury Rule with your resident. The second patient is an elderly woman presenting via EMS after a ground level fall in c-spine precautions. This time, you review the NEXUS Criteria for c-spine imaging with your resident. The third patient just got off a long flight and is short of breath. Once again, you find yourself on MDCalc, this time teaching the Well’s Criteria for pulmonary embolism and the PERC Rule. Your resident is very grateful for all the teaching, but asks, “we seem to spend a lot of time looking up decision instruments. Wouldn’t it be easier if these tools were just part of the electronic health record (EHR), since we are already inputting all the patient data into the EHR anyway?” You think to yourself, “interesting, I wonder what impact integration of these rules into the EHR would have on CT ordering in my group?” Background: Use of CT scanning has increased more than 20-fold since 1980[1],[2]. Although the CT is certainly a valuable tool, it is likely overused in emergency medicine.[3] CT has downstream harms, including radiation, incidental findings, over-diagnosis, financial costs, and negative impacts on emergency department throughput.[4][5] Numerous clinical decision rules, such as the Canadian CT Head Rule[6], the NEXUS c-spine tool[7], the PERC Rule[8], and the Well’s Criteria[9], have been developed to help guide appropriate imagining. However, uptake and appropriate use of these tools is not universal.[10] These authors question whether integration of a clinical decision support tool into the ordering system of the EHR would influence CT usage rates. Clinical Question: Does deploying a novel, evidence-based, electronic health record (EHR) integrated clinical decision support (CDS) tool influence overall utilization of three specific high cost CT imaging studies: head, c-spine and PE? Reference: Bookman K et al. Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High-cost Imaging in the Emergency Department: EmbED study. AEM July 2017. Population:...
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Read MoreSGEM Xtra: Andrew Worster – Legend of Emergency Medicine
Podcast Link: SGEM Xtra Andrew Worster Date: May 30th, 2017 Guest Skeptic: Dr. Andrew Worster. Andrew is a Professor of Emergency Medicine at McMaster University, home of evidence based medicine (EBM), Associate Member of Department of Health Research Methods, Evidence and Impact, creator of the Best Evidence in Emergency Medicine (BEEM) and my EBM mentor. Legends of Emergency Medicine: This is a new summer series of SGEM Xtras called Legends of Emergency Medicine. These episodes will highlight some of the pioneers and leaders of our specialty. I hope these episodes will give the next generation of emergency physicians access to some super stars in our field via social media. The format of the show will be similar. We will start by finding out some a non-medical thing about the legend: What song they picked as their music for the episode and why? Then we will tell the back story of how we first met. The more formal part of the episode asks the legend five questions. Listen to the podcast on iTunes to hear their responses. Five Questions: What is the biggest positive change you have seen in emergency medicine over your career? What is the biggest negative change you have seen in emergency medicine over your career? What contribution to emergency medicine that you made are you most proud of so far? What advice would you give to someone who is interested going into emergency medicine? How do you picture emergency medicine looking in the next ten years? Theme Music: Each legend was asked to pick theme music for their episode and explain why they picked that particular song. Andrew picked Sympathy for the Devil by the Rolling Stones. I hope you enjoy this summer SGEM Xtra series of podcasts. Don’t Panic – The SGEM will be back in the fall for Season#6. You can expect more critical appraisals of recent publications trying to cut the knowledge translation window down from over ten years to less than one year using the power of social media. The ultimate goal of the SGEM is for patients to get the best care based on the best evidence. Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency medicine. SGEM Xtra: Andrew Worster - Legend of Emergency Medicine [ 24:48 ] Play Now | Play in Popup |...
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Read MoreSGEM#184: We Weren’t Born to Follow-Up – The PEITHO Long-Term Follow-up Study
Podcast Link: SGEM184 Date: June 21st, 2017 Reference: Konstantinides et al. Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did her Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Kirsty is also the creator of a knowledge translation project called #PaperinaPic. Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. She is alert and talking, with a systolic blood pressure of 110 mmHg, but CTPA demonstrates bilateral pulmonary artery thrombus with right ventricular dilatation, and her troponin is raised. When you explain this, she asks if there isn’t something she could have to break up the clot. Background: We have discussed pulmonary embolism (PE) a number of times on the SGEM. In episode #51 and #126 we talked about managing some patients with PEs at home. Then in episode #163 we shuffled off to Buffalo and discussed ultrasound-facilitated, catheter directed, low-dose fibrinolysis for acute massive or submassive PEs. The 2015 Chest Guidelines recommend systemically administered thrombolytic therapy in patients with acute PE associated with hypotension (systolic BP<90mmHg) who do not have a high risk of bleeding (Kearon et al 2016). In patients with acute PE associated with hypotension (eg, systolic BP <90 mm Hg) who do not have a high bleeding risk, we suggest systemically administered thrombolytic therapy over no such therapy (Grade 2B). In addition, this guideline still suggests systemic thrombolytic therapy using a peripheral vein over catheter directed thrombolysis (CDT) in patients with acute PE who are treated with thrombolytic agents. They do note that patients with a higher risk of bleeding and have access to CDT are likely to choose CDT over systemic thrombolytic therapy. In patients with acute PE who are treated with a thrombolytic agent, we suggest systemic thrombolytic therapy using a peripheral vein over catheter directed thrombolysis (CDT) (Grade 2C). Remarks:Patients who have a higher risk of bleeding with systemic thrombolytic therapy and who have access to the expertise and resources required to do CDT are likely to choose CDT over systemic thrombolytic therapy. However, we’ve been left not sure...
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Read MoreSGEM#183: Don’t RINSE, Don’t Repeat
Podcast Link: SGEM183 Date: June 20th, 2017 Reference: Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Guest Skeptic: Jay Loosley is a Registered Nurse, and an Advanced Care Paramedic in London. His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. Case: A 71-year-old woman has a witnessed arrest while watching her granddaughter’s soccer game. By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation. She is not in a shockable rhythm. They continue CPR, get intravenous access, give a round of epinephrine and then wonder if they should start rapid cooling en-route to the hospital with some cold saline. Background: Therapeutic hypothermia post cardiac arrest has received a great deal of attention since 2002. Two relatively small randomized control trials published in the NEJM showed that hypothermia post cardiac arrest resuscitation was neuroprotective (Bernard et al and The Hypothermia after Cardiac Arrest Study Group). The Cochrane Collaboration updated their review on hypothermia for neuroprotection in adults after CPR in 2012. They concluded: “Conventional cooling methods to induce mild therapeutic hypothermia seem to improve survival and neurologic outcome after cardiac arrest. Our review supports the current best medical practice as recommended by the International Resuscitation Guidelines.” The SGEM was skeptical of prehospital cooling for OHCA after reviewing two studies on the subject (SGEM#21 and SGEM#54). Both papers showed no patient oriented benefit to pre-hospital cooling in patients with OHCA and return of spontaneous circulation (ROSC). Then came the Targeted Temperature Management (TTM) Trial (Nielsen et al NEJM 2013). The bottom line was the TTM trial did not demonstrate a benefit of a targeted temperature of 33C vs. 36C for survival of OHCA (SGEM#82). Clinical Question: Does rapid cooling by EMS with large volumes of 4C normal saline improve outcome in patients with OHCA receiving CPR? Reference: Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Population: Adults with OHCA that resuscitation was started, had IV access and were still in cardiac arrest after initial resuscitation efforts. Excluded: OCHA due to trauma, suspected intracranial bleed, known or suspected pregnancy, already cool (<34.5C) or patients with DNR. Intervention: Rapid infusion of 30ml/kg...
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Read MoreSGEM Xtra: FeminEM – Stronger Together
Podcast Link: SGEM Xtra FeminEM Date: June 20th, 2017 Guest Skeptic: Dr. Dara Kass is an Emergency Physician, mother of three, wife of one and champion for the evolution of women in medicine. She is also the Editor in Chief of FeminEM (Females in Emergency Medicine). This is an SGEM Xtra so we will not be doing a structured critical review of a recent paper trying to cut the knowledge translation window down for over 10 years to less than one year using the power of social media. The next episode of the SGEM will be a formal critical appraisal of a recent publication. Five Questions about FeminEM Why FeminEM? What is FeminEM? What is your Story? What is FIX2017? What are the Ultimate Goals of FeminEM? Listen to the podcast on iTunes to hear Dr. Dara Kass discuss these questions with me. For more information about FeminEM you can go to their website, like them on Facebook and follow them on Twitter. Other Resources on the Issue of Gender Equity Why do women physicians experience burnout more than men? Gender Gap: Do Male or Female Physicians Do More Housework? Female representation at Australasian specialty conferences Are there too few women presenting at emergency medicine conferences? When will we have enough women speakers in emergency medicine? Speaker Introductions at Internal Medicine Grand Rounds: Forms of Address Reveal Gender Bias Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine SGEM Xtra: FeminEM - Stronger Together [ 32:55 ] Play Now | Play in Popup |...
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Read MoreSGEM Xtra: IAEMC 2017 #Puravida
Date: June 14th, 2017 I had the pleasure of presenting at the Intra America Emergency Medicine Conference (#IAEMC17) held in Costa Rica last month. Thank you to Dr. Manrique Umana for inviting me and the conference organizers for putting on such an amazing and educational event. I had a fantastic time meeting so many wonderful people from South, Central and North America. I gave two talks during the conference and promised that all the material would be available for free as part of the FOAMed movement. Talk I: Knowledge Translation in the Digital Age The first talk was on knowledge translation (KT) in the digital age. It has been said that it can take 17 years for 14% of research to reach the patients’ bedside (Morris et al 2011). A number of examples of the KT problem were provided. The Pathman Leaky Pipe Model was used to illustrate seven leaks in KT. Social Media (FOAMed) was offered as a possible solution to the KT problem. Criticism of social media dating back 2,500 years were discussed (Tom Standage). A short list, not a complete list, of some quality FOAMed sites were provided. Copies of the slides can be downloaded from this link: KT in Digital Age PDF. Talk II: Five SGEM Episodes The second talk was five SGEM episodes selected by Dr. Manrique Umana. Manrique and his team are responsible for SGEM Global Spanish. They have done a number of translations into Spanish to remove language as a knowledge translation barrier and help cut the KT window down to less than one year. The most recent episode reviewed by the SGEM Global Spanish team is the Ottawa Heart Failure Risk Scale. A Star Wars theme was used for the presentation with an opening crawler written in Spanish. You can click on this link to view the video (The SGEM Returns Spanish). Five SGEM Episodes: The HEART Pathway: The HEART Pathway appears to have the potential to safely decrease objective cardiac testing, increase early discharge rates and cut median length of stay in low risk chest pain patients presenting to the emergency department with suspicion of acute coronary syndrome.. SGEM#151 Medical Expulsive Therapy for Kidney Stones: Expulsive therapy is unnecessary for ureteric stones < 5mm. There is some weak evidence that tamsulosin may help passage of larger stones (5 to 10 mm). SGEM#154 Simple Abscesses and Antibiotics: The addition of TMP/SMX to the treatment of uncomplicated cutaneous abscesses represents an opportunity for shared decision-making. SGEM#164 Management of Bronchiolitis: There seems to be a knowledge...
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Read MoreSGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It.
Podcast Link: SGEM182 Date: June 5th, 2017 Reference: Baharoglu et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016. Guest Skeptic: Dr. Robert Edmonds is an Emergency Medicine staff physician in Newport News, VA and a recent graduate of the University of Missouri-Kansas City EM residency. DISCLAIMER – The views and opinions of this podcast/blog do not reflect the views and opinions of the US Air Force, the United States Government, or Langley Air Force Base. Case: Your next patient is a 68-year-old with sudden onset right sided hemiparesis and facial droop. Non-contrast head CT shows a hemorrhagic stroke. On review of the patient’s medications you notice the patient is taking daily aspirin. You wonder if they would benefit from a platelet transfusion. Background: In the US, daily or every other day aspirin use has been reported to be as high as 61% in adults aged 65 or older (Ajani et al Am J Prev Med 2006). Taking antiplatelet therapy prior to a hemorrhagic stroke raises the risk of death by 27% and in high income countries more than 25% of patients with incident intracerebral hemorrhages were taking antiplatelet therapy (Thompson et al Neurology 2010). Many physicians are faced with patients with intracerebral hemorrhage on antiplatelets, and how to best manage them. The reversal of antiplatelet medications in intracerebral hemorrhage was covered in a Best Available Evidence (Martin and Conlon Ann Emerg Med 2013). It stated that “none of these studies showed a mortality benefit or improved functional outcome with platelet transfusion in patients with spontaneous or traumatic intracerebral hemorrhage who were receiving antiplatelet medications.” That review further elaborated that for these patients there were “no compelling data currently supporting the use of platelet transfusion” and that “it would be within the standard of care to withhold platelet transfusion in patients with either spontaneous or traumatic intracerebral hemorrhage who are receiving antiplatelet therapy.” The review did note that the existing evidence at that time were all based on relatively small and retrospective. However, recommendations from the neurosurgical perspective differ. A 2010 World of Neurosurgery literature review on the topic by Campbell et al “at present, the literature contains insufficient information to establish any guidelines or treatment recommendations. In light of this, the current authors have proposed a protocol for antiplatelet reversal in both spontaneous and traumatic acute ICH.” Clinical Question: Does platelet transfusion reduce death...
Most Recent Articles
SGEM Xtra: Diane Birnbaumer – Legend of Emergency Medicine
Podcast Link: SGEM Xtra Diane Birnbaumer Date: May 12th, 2017 Guest Skeptic: Dr. Diane Birnbaumer is a Senior Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is also an Emeritus Professor of Medicine at the David Geffen School of Medicine at UCLA. Diane will be a keynote speaker at FeminEM conference in New York City this October called FIX2017. Legends of Emergency Medicine: This is the second episode in the summer series of SGEM Xtras called Legends of Emergency Medicine. These episodes highlight some of the pioneers and leaders of our specialty. I hope these episodes will give the next generation of emergency physicians access to some super stars in our field via social media. The format of the show will be similar. We will start by finding out some a non-medical thing about the legend: What song they picked as their music for the episode and why? Then we will tell the back story of how we first met. The more formal part of the episode asks the legend five questions. Listen to the podcast on iTunes to hear their responses. Five Questions for Diane: What is the biggest positive change you have seen in emergency medicine over your career? What is the biggest negative change you have seen in emergency medicine over your career? What contribution to...
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SGEM#185: Every EHR Wants to “Rule” the World
Podcast Link: SGEM185 Date: July 11th, 2017 Reference: Bookman K et al. Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High-cost Imaging in the Emergency Department: EmbED study. AEM July 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 are working a very busy shift in the emergency department. Your first patient was involved in an motor vehicle collision (MVC), and you pulled up the app to review the Canadian CT Head Injury Rule with your resident. The second patient is an elderly woman presenting via EMS after a ground level fall in c-spine precautions. This time, you review the NEXUS Criteria for c-spine imaging with your resident. The third patient just got off a long flight and is short of breath. Once again, you find yourself on MDCalc, this time teaching the Well’s Criteria for pulmonary embolism and the PERC Rule. Your resident is very grateful for all the teaching, but asks, “we seem to spend a lot of time looking up decision instruments. Wouldn’t it be easier if these tools were just part of the electronic health record (EHR), since we are already inputting all the patient data...
Read More
SGEM Xtra: Andrew Worster – Legend of Emergency Medicine
Podcast Link: SGEM Xtra Andrew Worster Date: May 30th, 2017 Guest Skeptic: Dr. Andrew Worster. Andrew is a Professor of Emergency Medicine at McMaster University, home of evidence based medicine (EBM), Associate Member of Department of Health Research Methods, Evidence and Impact, creator of the Best Evidence in Emergency Medicine (BEEM) and my EBM mentor. Legends of Emergency Medicine: This is a new summer series of SGEM Xtras called Legends of Emergency Medicine. These episodes will highlight some of the pioneers and leaders of...
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SGEM#184: We Weren’t Born to Follow-Up – The PEITHO Long-Term Follow-up Study
Podcast Link: SGEM184 Date: June 21st, 2017 Reference: Konstantinides et al. Impact of Thrombolytic Therapy on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did her Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Kirsty is also...
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SGEM#183: Don’t RINSE, Don’t Repeat
Podcast Link: SGEM183 Date: June 20th, 2017 Reference: Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Guest Skeptic: Jay Loosley is a Registered Nurse, and an Advanced Care Paramedic in London. His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. Case:...
Read More
SGEM Xtra: FeminEM – Stronger Together
Podcast Link: SGEM Xtra FeminEM Date: June 20th, 2017 Guest Skeptic: Dr. Dara Kass is an Emergency Physician, mother of three, wife of one and champion for the evolution of women in medicine. She is also the Editor in Chief of FeminEM (Females in Emergency Medicine). This is an SGEM Xtra so we will not be doing a structured critical review of a recent paper trying to cut the knowledge translation window down for over 10 years to less than one...
Read More
SGEM Xtra: IAEMC 2017 #Puravida
Date: June 14th, 2017 I had the pleasure of presenting at the Intra America Emergency Medicine Conference (#IAEMC17) held in Costa Rica last month. Thank you to Dr. Manrique Umana for inviting me and the conference organizers for putting on such an amazing and educational event. I had a fantastic time meeting so many wonderful people from South, Central and North America. I gave two talks during the conference and promised that all the material would be available for free as part of the FOAMed movement....
Read More
SGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It.
Podcast Link: SGEM182 Date: June 5th, 2017 Reference: Baharoglu et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016. Guest Skeptic: Dr. Robert Edmonds is an Emergency Medicine staff physician in Newport News, VA and a recent graduate of the University of Missouri-Kansas City EM residency. DISCLAIMER – The views and opinions of this podcast/blog do not reflect the views and opinions of the US...
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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?
Podcast Link: SGEM181 Date: June 3rd, 2017 Reference: Sierink et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet August 2016. Guest Skeptic: Dr. Marcel Emond is an Associate Professor, Laval University, Emergency Physician at the Level 1 Trauma Center of the CHU de Québec, a Senior Clinician-Scientist, Chair of CAEP Trauma and Injury prevention committee, BEEM faculty member and the host of SGEM Global French. Case: A...
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SGEM#180: The First Cut is the Deepest – N.O.T. for Paediatric Appendicitis
Podcast Link: SGEM180 Date: May 24th, 2017 Reference: Georgiou et al. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Pediatrics 2017. Guest Skeptic: Dr. Ross Fisher is a Paediatric Surgeon in Sheffield, England. When he is not waxing lyrical about presentation skills (P Cubed) over at ffolliet.com, giving the Greatest Presentation in the World at SMACC or expounding his views on paediatric trauma management he can be found at Sheffield Children’s Hospital principally dealing with surgical oncology, vascular access and all...
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SGEM#179: Chase the Dragon and Naloxone
Podcast Link: SGEM179 Date: May 19th, 2017 Reference: Willman et al. Do heroin overdose patients require observation after receiving naloxone? Clinical Toxicology 2017. Guest Skeptic: Dr. Richard Hamilton (@RJHamiltonMD) is Chair of the Department of Emergency Medicine at Drexel University College of Medicine. He is also the host of EMToxCast and gave a talk at the Association of Academic Chairs of Emergency Medicine Annual Retreat called: Can Social Media Save Emergency Medicine? Case: A 45-year-old male arrives via emergency medical services (EMS) complaining that he wants to be discharged....
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SGEM#178: Mindfulness – It’s not Better to Burnout than it is to Rust
Podcast Link: SGEM178 Date: May 12th, 2017 Reference: Ireland et al. A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher 2017. Guest Skeptic: Dr. Diane Birnbaumer is a Senior Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is also an Emeritus Professor of Medicine at the David Geffen School of Medicine at UCLA. Case: A resident comes to you looking for advice. He is having trouble feeling tired, short-tempered and it is affecting his work...
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