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SGEM#222: Rhythm is Gonna Get You – Into an Atrial Fibrillation Pathway

Posted by on Jun 16, 2018 in Cardiac, Featured, Podcasts | 0 comments

Podcast Link: SGEM222 Date: June 12th, 2018 Reference: DeMeester S et al. Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. 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 and an amazing photographer.   Case: A 62-year-old Canadian is on vacation in up-state Michigan, and after a celebratory evening, presents to your emergency department with palpitations. “I’ve had atrial fibrillation a number of time before. Usually they just shock me and send me home.” Local practice is usually to treat rapid atrial fibrillation with a calcium channel blocker infusion and admit to hospital. As the conversation progresses, you wonder whether it might be safe to discharge some atrial fibrillation patients home for outpatient follow-up. Background: Atrial fibrillation, rate control vs. rhythm control. This is a debate that has gone on for many years. It is like normal saline vs. Ringer’s lactate for fluid resuscitation, steroids vs. no steroids for sepsis, or Coke vs. Pepsi. Atrial fibrillation is one of the most common dysrhythmias and patients often present to the emergency department with increased heart rates, chest pain and weakness among other presentations. The debate has...

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SGEM#221: Smells Like Isopropyl Alcohol for Nausea

Posted by on Jun 9, 2018 in Featured, GastroIntestinal, Podcasts | 0 comments

Podcast Link: SGEM221 Date: June 8th, 2018 Reference: April MD, et al. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. Ann Emerg Med 2018 Guest Skeptic: Meghan Groth is a pharmacist who has been practicing in emergency medicine for the past six years. She’s recently transitioned into industry, taking on a position as a medical science liaison in New England. She’s been a contributor for the Academic Life in Emergency Medicine and Emergency Medicine PharmD blogs and is a member of the ALiEMU Capsules team. Case: A 32-year-old woman presents to your emergency department with complaints of nausea (nausea VAS is about a 5 on a scale of 0 to 10) and states she’s worried she’s coming down with some sort of stomach flu. She’s hemodynamically stable and looks a bit queasy but isn’t actively retching when you see her. Background: Nausea and vomiting are frequent complaints of patients presenting to the emergency department, accounting for just under five million visits per year. A number of prescription medications are available to treat these symptoms, including ondansetron, droperidol, metoclopramide, promethazine, and prochlorperazine. The most commonly utilized antiemetic in US emergency departments is ondansetron, a 5-HT 3 antagonist. Despite its widespread use, a dose of intravenous ondansetron takes about 30 minutes to...

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SGEM Xtra: Don’t Give Up – The Power of Kindness with Brian Goldman

Posted by on Jun 2, 2018 in Featured, Podcasts, Psychiatric | 0 comments

Podcast Link: SGEM Xtra Kindness with Brian Goldman Date: May 26th, 2018 This is a SGEM Xtra book review. I had the honour of meeting and interviewing Dr. Brian Goldman at the Canadian Association of Emergency Physician (CAEP) annual scientific assembly in Calgary. Dr. Goldman is an Emergency Medicine physician who works at Mount Sinai hospital in Toronto. He is the host of CBC radio show White Coat Black Art and the author of the bestselling books The Night Shift...

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SGEM#220: Acupuncture vs. Morphine for Renal Colic

Posted by on May 26, 2018 in Featured, Genitourinary, Podcasts | 0 comments

Podcast Link: SGEM220 Date: May 16th, 2018 Reference: Beltaief K et al. Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial. J Pain Res. 2018 Guest Skeptic: Dr. Tony Seupaul  is the Chairman of the Department of Emergency Medicine, University of Arkansas. Dr. Cordell Cunningham is a PGY 2 in Emergency Medicine at University of Arkansas for Medical Sciences Case: A 51-year-old man presents to the emergency department complaining of right flank pain radiating to his groin like his previous episodes of renal...

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SGEM#219: Shout, Shout, PERC Rule Them Out

Posted by on May 19, 2018 in Cardiac, Featured, Podcasts, Pulmonary | 0 comments

Podcast Link: SGEM219 Date: May 16, 2018 Reference: Freund et al. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events
 Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. JAMA February 2018. Guest Skeptic: Dr. Jeffrey Kline (@klinelab) is the Vice Chair of Research in Emergency Medicine and a professor of physiology, Indiana University School of Medicine. He is the editor in chief of AEM, creator of Pulmonary Embolism Rule-out Criteria (PERC) Rule and has published extensively in the...

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SGEM#218: Excited Delirium Syndrome

Posted by on May 12, 2018 in Featured, Neurologic, Pharmacology/Toxicology, Podcasts, Psychiatric | 0 comments

Podcast Link: SGEM218 Date: May 12th, 2018 Reference: Gonin P et al. Excited Delirium: A Systematic Review. AEM May 2018. Guest Skeptic: Dr. Chris Bond 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: A 24-year-old male is brought into the emergency department by police....

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SGEM#217: The Batman Effect on Improving Perseverance

Posted by on May 5, 2018 in Featured, Podcasts, Psychiatric | 0 comments

Podcast Link: SGEM217 Date: March 6th, 2018 Reference: White et al. The “Batman Effect”: Improving Perseverance in Young Children. Child Development December 2016. Guest Skeptic: Dr. Casey Parker is a rural Generalist working in Broome, Australia. He has particular interests in Emergency Care, Aboriginal Health, Paediatrics, Trauma and Women’s Anaesthesia. Casey has this great blog and podcast called Broome Docs. Casey and I made a #Batdoc video at SMACCdub. Case: It is flu season and there is an endless stream of patients with...

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SGEM Xtra: Petition to Retire the Surviving Sepsis Campaign Guidelines

Posted by on May 2, 2018 in Featured, Infectious, Podcasts | 0 comments

Recently the SGEM was contacted by a group of doctors organizing a petition. They were concerned about the new Surviving Sepsis Campaign (SCC) guidelines that were just released. Specifically, the fluid, antibiotics and pressor requirements within the first hour of being triaged in the emergency department. The SGEM was invited to be involved in a global effort to express the concerns about the SSC guidelines. Below is the letter being released from a number of #FOAMed people from around...

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SGEM#216: Pump It Up – Corticosteroids for Patients with Pneumonia Admitted to Hospital

Posted by on Apr 28, 2018 in Featured, Infectious, Podcasts, Pulmonary | 0 comments

Podcast Link: SGEM216 Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Cochrane Database of Systematic Reviews. December 2017. Guest Skeptic: Dr. Jake Turner, a foundation doctor working in the UK. Case: A 72-year-old gentleman presents to your emergency department. He has been generally unwell for around one week, with a worsening cough, shortness of breath and fever. He is now feeling extremely short of breath, appears confused and is pyrexial at 39 degrees centigrade. His observations are heart...

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SGEM#215: Love Will Tear Us Apart – Diagnostic Challenges of Aortic Dissection

Posted by on Apr 21, 2018 in Cardiac, Featured, Podcasts | 0 comments

Podcast Link: SGEM215a Date: April 12th, 2018 Reference: Ohle R et al. Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis. AEM April 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine (AEM). Case: You are in the emergency department caring for a 65-year-old man with sharp chest pain radiating to the back. Blood pressure is elevated, and his pain was sudden in onset. His chest x-ray is...

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SGEM#214: Woman – The TXA Trial for Post-Partum Hemorrhage

Posted by on Apr 14, 2018 in Featured, Gynecologic, Hematologic, Podcasts | 0 comments

Podcast Link: SGEM214 Date: April 13th, 2018 Reference: Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. The Lancet 2017 Guest Skeptic: Dr. Nick Papalia completed his MD at Western University. He is currently completing his third year of Obstetrics and Gynecology residency at the University of Calgary. Case: 37-year-old primiparous woman has a spontaneous vaginal delivery following an induction of labour at 39 weeks for gestational diabetes...

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SGEM Xtra: The Danger Within Us

Posted by on Apr 7, 2018 in Featured, Podcasts | 3 comments

Podcast Link: SGEM Xtra Danger Within Us Date: March 23rd, 2018 This is a SGEM Xtra book review. I had the pleasure of interviewing Jeanne Lenzer. She is an award-winning independent medical investigative journalist who has written for the BMJ. Jeanne has also written for the Atlantic, the New York Times Magazine, Mother Jones, Huffington Post and Slate. Jeanne book is called The Danger Within Us: America’s Untested, Unregulated Medical Device Industry and One Man’s Battle to Survive It. In the book, she takes a critical look at the medical...

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