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SGEM#179: Chase the Dragon and Naloxone

Posted by on May 21, 2017 in Featured, Pharmacology/Toxicology, Podcasts, Pulmonary | 2 comments

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. EMS states they found him unresponsive and with paraphernalia consistent with intravenous heroin use. His prehospital vital signs were oxygen saturation of 89% and respiratory rate of six breaths per minute prior to administration of oxygen and 1 mg of naloxone. After naloxone administration he is alert and oriented times three with a normal pulse oximetry and clear lung fields. It is 20 minutes after he received naloxone and he is asking to be discharged. Background: Heroin use has been increasing in the USA since 2007 (1). Opioids depress the heart rate and breathing and overdoses can result in death. With the increase in heroin use there has also been an increase in the number of heroin deaths (2). Naloxone is the specific treatment for heroin overdoses and is becoming widely available to first responders...

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SGEM#178: Mindfulness – It’s not Better to Burnout than it is to Rust

Posted by on May 14, 2017 in Featured, Podcasts, Psychiatric | 4 comments

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 interactions and personal sense of satisfaction with his job. You suspect he is suffering from early burnout. Background: Burnout is certainly a hot topic, and mindfulness has hit the front pages of the New York Times and Time Magazine, putting it front and center in the public eye. Burnout was a term coined by Herbert Freudenberger in 1974 (1). There are a number of ways to define burnout but one of the most widely known is by Maslach, known for the Burnout Inventory (MBI) Score. It has three components including emotional exhaustion, depersonalization and reduced feelings of personal accomplishment (2). Some ACEP members know about the MBI as it has been available as part of the Wellness Booth at the ACEP Scientific Assembly for over 20 years. Physicians have reported a high level of burnout. A...

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SGEM#177: POCUS – A New Sensation for Diagnosing Pediatric Fractures

Posted by on May 7, 2017 in Featured, Musculoskeletal, Pediatrics, Podcasts | 38 comments

Podcast Link: SGEM177 Date: May 1st, 2017 Reference: Poonai et al. Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 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 SGEM HOP: This is another SGEM Hot Off the Press with Academic Emergency Medicine. Here is a reminder of...

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SGEM#176: Somebody’s Watching Me – Cardiac Monitoring for Chest Pain

Posted by on Apr 30, 2017 in Cardiac, Featured, Podcasts | 2 comments

Podcast Link: SGEM176 Date: April 26th, 2017 Reference: Syed et al. Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring. CMAJ Jan 2017 Guest Skeptics: Drs. Ryan Tam and Antony Robert are chief residents from the Royal College Emergency Medicine Program at McGill University. Ryan Tam’s academic interests include quality improvement, ultrasound and simulation. He is also involved with a start-up FOAMed site called EM-bites...

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SGEM#175: Dancing on the Ceiling with Ketorolac for Pain

Posted by on Apr 23, 2017 in Featured, Podcasts | 10 comments

Podcast Link: SGEM175 Date: April 20th, 2017 Reference: Motov et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med Dec 2016 Guest Skeptic: Dr. Ken Milne is a front line community emergency medicine physician passionate about skepticism, evidence based medicine and knowledge translation. He is also the moderator for Emergency Medical Abstracts, faculty member of Best Evidence in Emergency Medicine and creator of the Skeptics’ Guide to...

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SGEM#174: Don’t Believe the Hype – Vitamin C Cocktail for Sepsis

Posted by on Apr 9, 2017 in Featured, Infectious, Podcasts | 11 comments

Podcast Link: SGEM174 Date: April 6th, 2017 Reference: Marik et al. Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest Dec 2016 Guest Skeptic: Dr. Jeremy Faust is an attending emergency physician at Brigham and Women’s Hospital in Boston Massachusetts and an instructor at Harvard Medical School. He’s the co-host of FOAMcast with co-host Dr. Lauren Westafer and he’s written about sepsis in the Annals of Emergency Medicine, EM Clinics of North America,...

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SGEM Xtra: Talk Trauma 2017- Tales from the Outer Rim

Posted by on Apr 7, 2017 in Conferences, Featured, Hematologic, Musculoskeletal, Podcasts, Trauma | 0 comments

Date: April 7th, 2017 Superstar Nurse Brenda Palsa and I had a wonderful time presenting at Talk Trauma 2017 this week in London, Ontario. It is a one day conference for nurses, allied health & EMS professionals involved in providing care for adult and paediatric trauma patients. Talk Trauma is put on by the London Health Science Centre (LHSC). We were honoured to return for a second year in a row to talk about managing trauma patients in the periphery....

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SGEM#173: Diazepam Won’t Get Back Pain Down

Posted by on Apr 2, 2017 in Featured, Musculoskeletal, Podcasts | 1 comment

Podcast Link: SGEM173 Date: March 21st, 2017 Reference: Friedman BW et al. Diazepam is no better than placebo when added to naproxen for acute low back pain. Ann Emerg Med 2017. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of EM at NYU/Bellevue Hospital in the Department of Emergency Medicine. He is also part of REBEL EM, The Teaching Course and Core EM. Case: A 43-year-old woman who presents with an acute onset of back pain. She states she was carrying some...

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SGEM Xtra: Pura Vida IAEMC 2017

Posted by on Mar 31, 2017 in Conferences, Featured, Podcasts | 0 comments

Podcast Link: SGEM Xtra Pura Vida Date: March 23rd, 2017 Guest Skeptic: Dr. Manrique Umaña: Specialist in Emergency Medicine (ME), working as an assistant at San Juan de Dios Hospital and Hospital Cima, in San José, Costa Rica. He is the current National Coordinator and Professor of the Postgraduate Emergency Medicine (University of Costa Rica). He is also Professor of the Chair of Internal Medicine (UCIMED), member of the Costa Rican Association of Emergency Physicians (ASOCOME) and International member of ACEP...

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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 | 3 comments

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...

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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...

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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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