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SGEM#207: Ahh (Don’t) Push It – Pre-Hospital IV Antibiotics for Sepsis.

Posted by on Feb 17, 2018 in Featured, Infectious, Podcasts | 9 comments

Podcast Link: SGEM207 Date: February 14th, 2018 Reference: Alam N et al. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. The Lancet Nov 2017. Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service. Case: EMS is dispatched to a retirement home. They have a 73-year-old man who complains of weakness and a cough for the last 48 hours. You arrive and find the man lying in bed looking ill. He has a history of hypertension, benign prostatic hypertrophy and osteoarthritis. His medications include ramapril, hydrochlorothiazide and tamsulosin. On examination, he has a temperature of 38.7C, heart rate of 105 beats per minute, respiratory rate of 26, oxygen saturation of 88%. and a blood pressure of 88/50 mmHg. You load him on the stretcher, start an intravenous of normal saline and provide some supplemental oxygen via face mask. Clearly something infectious is going on and you wonder if starting antibiotics on route to the hospital would help? Background: We have covered sepsis many times on the SGEM over the years (SGEM# 69, 90, 92, 113, and 168). It is a serious condition associated with high morbidity and mortality. Other serious time-dependent conditions such as myocardial infarction and trauma have been...

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SGEM#206: I’m Wheezy Like A Pre-Schooler – Prednisolone for Wheezy Children

Posted by on Feb 10, 2018 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 10 comments

Podcast Link: SGEM206a Date: February 6th, 2018 Reference: Foster SJ et al. Oral prednisolone in preschool children with virus-associated wheeze: a prospective, randomised, double-blind, placebo-controlled trial. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. She is also the co-founder of Don’t Forget the Bubbles and on the FeminEM Speaker Bureau. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. He has been taking salbutamol at home today but he’s still not improving. He has mild work of breathing and a bilateral wheeze. His oxygen saturation is 94% on room air. Tom has no other previous medical history. You start to write up the salbutamol, but should you give him a dose of prednisolone too? Background: We see “little wheezers” in the emergency department all the time. It is really common during the winter months and often due to a viral infection (1). There has always been some uncertainty about the benefit of prednisolone for viral wheeze in pre-school children. In 2009, a study by Panickar et al found no positive effect in giving steroids to pre-school children with wheeze (2). Since then, our practice, and our treatment guidelines, have changed, in spite of questions about...

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SGEM#205: Twist & Shout – Testicular Torsion

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

Podcast Link: SGEM205 Date: January 31st, 2018 Reference: Frohlich LC, et al. Prospective validation of clinical score for males presenting with an acute scrotum. AEM Dec 2017. Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. Melissa is passionate about clinical and translational research and focuses most of her work on the use of capnography or end-tidal carbon dioxide monitoring. In her spare time, Melissa also enjoys being the fellowship director to an...

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SGEM#204: Hold the Line – IVs Aren’t Always Required

Posted by on Jan 28, 2018 in Featured, Podcasts | 22 comments

Podcast Link: SGEM204 Date: January 25th, 2018 Reference: Hawkins et al. Peripheral Intravenous Cannula Insertion and Use in the Emergency Department: An Intervention Study. AEM Jan 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency. Case: You are caring for a patient with a fever in the emergency department and the nurse asks if you want to start an intravenous (IV) line or just draw blood. You think for a minute…your...

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SGEM Xtra: Eight Days a Week

Posted by on Jan 26, 2018 in Administration, Featured, Podcasts | 0 comments

Podcast Link: SGEM Xtra Eight Days a Week Date: January 26th, 2018 Happy New Years again SGEMers. This is just a quick SGEM Xtra episode to let you know what I am going to be trying to do in 2018 to help you cut the knowledge translation (KT) window down from over ten years to less than one year. It involves following a weekly schedule of social media interaction.   Weekly SGEM Schedule   Saturday/Sunday SGEM: A new episodes of the SGEM will...

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SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid

Posted by on Jan 20, 2018 in Featured, Infectious, Pharmacology/Toxicology, Podcasts, Pulmonary | 5 comments

Podcast Link: SGEM203 Date: January 15th, 2018 Reference: Sadeghirad B, et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, and is a part of the ALiEM Capsules Team.  Case: 50-year-old man presents with a one day history of sore throat, cough and...

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SGEM#202: Lidocaine for Renal Colic?

Posted by on Jan 14, 2018 in Featured, Genitourinary, Podcasts | 10 comments

Podcast Link: SGEM202 Lidocaine Date: January 9th, 2018 Reference: Soleimanpour H et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of Arkansas. Knowledge Translation Window: A short note to point out that this paper was not published in the last year. However, it is less...

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SGEM#201: It’s in the Way That You Use It – Ottawa SAH Tool

Posted by on Jan 7, 2018 in Featured, Neurologic, Podcasts | 8 comments

Podcast Link: SGEM201 SAH Date: December 19th, 2017 Reference: Perry J et al. Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ Nov 2017 Guest Skeptic: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and Critical Care course. Case:  A 35-year-old female presents to your emergency department three-hours after the onset of a severe frontal headache.  She describes the headache as throbbing, left retro-orbital, and associated with nausea...

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SGEM Xtra: I Am Woman

Posted by on Dec 29, 2017 in Featured, Holiday, Podcasts | 1 comment

Podcast Link: SGEM Xtra I Am Woman Date: December 28th, 2017 This is a special year end episode of the SGEM. It is time to reflect upon 2017 while at the same time look forward to 2018. It has been an incredible year for a number of reasons. We had some fantastic papers to review, excellent guest skeptics and super SGEM Xtras. I am very energized to keep the momentum rolling for this knowledge translation project in 2018. From my perspective,...

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SGEM Xtra: Every Day I Write the Book – SGEM Season#3

Posted by on Dec 25, 2017 in Featured, Holiday, Podcasts | 1 comment

Podcast Link: SGEM Xtra Season#3 Date: December 25th, 2017 Happy holidays to all the SGEMers. Please accept this PDF book of Season#3. It is a holiday gift from me to you to say thank you for all the support and encouragement over the last few years. There are now close to 35,000 subscribers and the SGEM is translated into four other languages. Who would have thought back in 2012 that an emergency medicine  physician from Canada could reach so many people...

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SGEM#200: Dr. Alexander Hamilton and Bloodletting for Camp Fever

Posted by on Dec 23, 2017 in Featured, Holiday, Infectious, Podcasts | 1 comment

Podcast Link: SGEM200 Date: December 19th, 2017 Reference: Lesassier Hamilton A. Dissertatio Medica lnauguralis De Synocho Castrensi [Inaugural medical dissertation on camp fever]. Edinburgh: J Ballantyne, 1816. Guest Skeptic: Dr. Robert Leeper is an assistant professor of surgery at Western University and the London Health Sciences Centre.  His practice is in trauma, emergency general surgery, and critical care with an academic interest in ultrasound and medical simulation. This is the 200th episode of the SGEM and it is the 2017 holiday edition....

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SGEM#199: Therapeutic Hypothermia – What is it Good For?

Posted by on Dec 17, 2017 in Featured, Neurologic, Podcasts | 4 comments

Podcast Link: SGEM199 Date: November 27th, 2017 Reference: Legriel et al. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure. He is known to have poorly controlled epilepsy. It...

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