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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 | 1 comment

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 Teaching Coop. Jesse classes himself a lifelong student of teaching, learning, health and human performance. Case: You are working night shift in the emergency department. Two patients present to the front desk in close succession, brought in by concerned family members. Both are similarly hypotensive and tachypnoeic,drowsy but orientated, with hot, reddened and increasingly painful cellulitis. Following the triage sepsis pathway, recently amended to use qSOFA. The nurse triages both to beds in the acute/resuscitation area of the department. Each patient is seen quickly and has initial vital signs and blood samples obtained. One patient has a temperature of 38.3C and the other 35.5C. Being a night shift, staff resources are tight. How do you allocate resources wisely? Background:  If you work in emergency medicine, you are probably aware of the continuous debate about fever. Is...

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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 York and is a Best Evidence in Emergency Medicine (BEEM) presenter and author. This episode is based upon a BEEM critical review. Case: A four-year old male who is a known asthmatic presents to the emergency department with an asthma exacerbation. He has been sick with an upper respiratory infection for the last two days. He is getting worse despite his mother giving albuterol every four hours. You order three treatments with albuterol and atrovent and you ask the medical student who is with you, which would be the best steroid to give to this patient by mouth and why? Background: Untill recently prednisolone have been the standard of care for oral steroids used in the treatment of an asthma exacerbation.  But this medication has a bitter taste which can make it very hard to administer to...

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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 | 3 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 | 0 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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SGEM#190: Wee are the Champions of Pediatric Urine Samples

Posted by on Oct 1, 2017 in Featured, Genitourinary, Infectious, Pediatrics, Podcasts | 3 comments

Podcast Link: SGEM190 Date: September 26th, 2017 Reference: Kaufman, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ April 17. Guest Skeptic: Dr. Natalie May trained as an emergency physician with subspecialty paediatric emergency medicine in the UK and worked in Manchester and Oxford before moving to Australia in 2015 to work for Sydney HEMS. She’s been there for the last 18 months working in prehospital and retrieval medicine and then in Emergency Medicine. She is a...

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SGEM Xtra: CALS Conference on Rural Emergency Care

Posted by on Sep 30, 2017 in Conferences, Featured, Podcasts | 0 comments

Date: Sept 30th, 2017 I had the pleasure of presenting at the CALS Conference on Rural Emergency Care held in beautiful Minneapolis, Minnesota yesterday.  Thank you to Dr. Todd Grant and the conference committee for inviting me. Everyone made me feel very welcome. The keynote address was called Looking Back/Looking Ahead. I was asked to look back over my career providing rural emergency care and look ahead to the future of rural emergency care. There were five objectives to the presentation: 1) Define...

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SGEM#189: Bring Me To Life in OHCA

Posted by on Sep 24, 2017 in Cardiac, Featured, Podcasts | 9 comments

Podcast Link: SGEM189 Date: September 19th, 2017 Reference: Cournoyer et al. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. September 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician 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 the medical director of an EMS system in a large city deciding on whether to respond to all...

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