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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 Emergency Medicine. Case: A 37-year-old, presents to the emergency department with sudden onset right-sided flank pain, hematuria and vomiting. He rates his pain as 8/10 and is writhing around on the stretcher. He says it feels like his previous kidney stones. His vital signs are within normal limits. You perform a quick bedside ultrasound, which reveals a normal aorta and mild right-sided hydronephrosis. You diagnose him with renal colic and he is requesting analgesia. He says morphine has made him nauseous in the past, but a shot of 30mg of ketorolac has helped. You decide to start by giving ketorolac and an anti-emetic. What dose of ketorolac do you give? Background: Ketorolac is a commonly used non-steroidal anti-inflammatory drug (NSAID) used in the emergency department for treatment of moderate to severe acute pain (1) Unlike...

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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 | 5 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, and for mainstream audiences in Slate.  Case: A 60 year-old man is admitted to the ICU with severe sepsis from pneumonia. He has a history of hypertension and diabetes. You are providing him with intravenous fluids and appropriate antibiotics. When speaking with the family his son asks about a vitamin C cure he just read about? Background: We have covered sepsis many times on the SGEM (#44, 69, 90, 92 and 113). Most recently we covered the HYPRESS Trial on SGEM#168. The primary outcome was that hydrocortisone did not prevent the development of septic shock. The secondary outcomes also showed no difference in mortality. There has been a huge buzz in the media about a vitamin C cocktail (vitamin C, hydrocortisone and thiamine) as a possible cure for sepsis. Many FOAMed sites have joined the...

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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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SGEM#169: Stuck in the Middle with Food (Glucagon for Esophageal Foreign Body Impaction)

Posted by on Feb 5, 2017 in Featured, GastroIntestinal, Podcasts | 4 comments

Podcast Link: SGEM169 Date: February 2nd, 2017 Reference: Bodkin et al. Effectiveness of glucagon in relieving esophageal foreign body impaction: a multicenter study. AJEM June of 2016 Guest Skeptic: : Meghan Groth (@EMpharmGirl) is an emergency medicine pharmacist. She has contributed to the Academic Life in Emergency Medicine (AliEM) and Emergency Medicine PharmD blogs, and is a member of the ALiEMU Capsules team. Case: It’s the day after St. Patrick’s Day, and you have a 28-year-old man that presents to the emergency department...

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SGEM#168: HYPRESS – Doesn’t Got the Power

Posted by on Jan 22, 2017 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM168 Date: January 19th, 2017 Reference: Keh D et al. Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis: The HYPRESS Randomized clinical Trial. JAMA 2016. Guest Skeptic: Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas. He is the founder and creator of REBEL EM and REBEL Cast as well as the co-creator and co-founder of the Teaching Institute, a medical education startup company trying to change the...

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SGEM Xtra: CAEP Choosing Wisely

Posted by on Dec 28, 2016 in Featured, Holiday, Podcasts | 0 comments

Podcast Link: SGEM Xtra CAEP Choosing Wisely Date: November 29th, 2016 Guest Skeptic: Dr. Amy Cheng is an Emergency Physician, the Emergency Department Director of Quality Improvement and the Interim Medical Director of Quality and Patient Safety, at St. Michael’s Hospital in Toronto. She is also the National Co-Chair for Choosing Wisely Canada in Emergency Medicine. This is another SGEM Xtra over the holiday season. There are a lot of top ten lists released at this time of year. The...

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SGEM#167: The Management of Bronchiolitis in Community Hospitals

Posted by on Dec 18, 2016 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 12 comments

Podcast Link: SGEM167 Date: December 14th, 2016 Reference: Plint et al. Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study. CJEM November 2016 Guest Skeptic: Dr. Chris Bond. Chris 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:...

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