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Read MoreSGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes
Podcast Link: SGEM161 Date: September 21st, 2016 Reference: Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 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: A 49-year-old male presents to the emergency department after being in a motor vehicle collision. You diagnose him with an isolated sternal fracture on X-ray. Specifically there are no rib fractures or lung abnormalities identified. He also has a normal ECG and troponin. As you are preparing to discharge him, he asks if there are any potential complications to expect from the injury, and how long he should expect to have pain? Background: Sternal fractures are often the result of a significant blunt thoracic trauma and have an incidence between 0.33% of all trauma patients (Recinos et al and 3.7% of patients admitted after a motor vehicle accident (Yeh et al). Poor outcomes in patients with sternal fracture are associated with the severity of other injuries, complications and pre-existing comorbidities (Yeh et al). Many studies have demonstrated that a patient with an isolated fracture of the sternum can be safely discharged from the emergency department after an appropriate investigation (Hossain M, Khoriati et al and Kouritas et al), which should include cardiac biomarkers and ECG (Clancy et al). Therefore, the clinical significance of isolated sternal fracture has change over the past years and admission is no longer required for those patients. When looking at other minor thoracic injuries discharged from emergency department, delayed hemothorax has been reported as a significant delayed complication (Misthos et al and Plourde et al) and a risk factor for poor functional outcome (Emond et al). Clinical Question: What are the complications and outcomes of patients with isolated sternal fracture discharged from the emergency department compared to those with other minor thoracic injury? Reference: Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 2016 Population: Patients 16 years and older presenting to the emergency department with minor thoracic trauma defined by the presence of chest abrasion or contusion, or suspected or radiographically confirmed rib fracture. Exclusion criteria: The presence of a hemothorax, pneumothorax, lung contusion...
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Read MoreSGEM#160: Oh Baby, You’re Too Sensitive – High Sensitivity Troponin
Podcast Link: SGEM160 Date: September 8th, 2016 Reference: Body et al. The use of very low concentrations of high sensitivity troponin T to rule out acute myocardial infarction using a single blood test. AEM Sept 2016. 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. This is a SGEM Hot Off the Press episode. Here is a summary of the process but you can click on the SGEMHOP link for more details and previous episodes: A peer reviewed paper is selected pre-publication from AEM or CJEM that we think will be of interest to the SGEMers. We do a structured critical review of the paper using the quality check list developed by the Best Evidence in Emergency Medicine (BEEM) group. The paper is then discussed with one of the paper’s authors to give us a better understanding of the strengths and weaknesses of the paper. A blog and podcast are posted encouraging the FOAMed world to engage with us and the author over a one week period. A summary of the critical review and the best social media engagement is then published in AEM or CJEM to help cut that knowledge translation window down. SGEMHOP from AEM Now has CME Credits We have some exciting news to start Season# 5 of the SGEM. Hot off the Press papers from AEM will now have continuing medical education (CME) credits attached to the episodes. Dr. Corey Heitz will be writing up the five questions and alternating with Justin as the guest skeptic. Corey is an associate professor of emergency medicine at the Virginia Tech Carilion School of Medicine in Roanoke Virginia. He has been a member of the executive board of the Clerkship Directors in Emergency Medicine, is co-chair of the National EM M4 Examination committee and sits on the examination development board for the NBME EM-Advanced Clinical Exam. In addition, Corey is the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the AAEM MedEdPORTAL. SGEMers can claim their CME credits by following this process: Go to the Wiley Health Learning website Register and create a log in Search for “Academic Emergency Medicine – September” Complete the five questions and submit your answers As this is a new feature there may be some glitches. Please email Corey with any questions or difficulties. Case: A...
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Read MoreSGEM Xtra: Freeze Frame – Paper in a Pic
Podcast Link: SGEM Xtra PaperinaPic Date: September 1st, 2016 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. This is an SGEM Xtra summer content episode. But don’t panic we will be back later this month to launch Season # 5 of the SGEM…better, stronger, faster than it was before – cutting that knowledge translation window down from over ten years to less than one year using the power of social media. In this episode I ask Kirsty five questions about infographics and five questions about her Paper In A Pic (#PaperinaPic) knowledge translation project. Listen to the podcast to hear her responses. You can check out her SGEM infographics by clicking on #PaperinaPic. Additional Resources and Examples of Infographics: Definition of Infographic Wikipedia Infographics Florence Nightingale; the mother of Infographics? Propofology Infographs CanadiEM AHA 2015 Video of Kirsty with BatDoc at SMACCDub. I hope everyone enjoys the last few days of summer and we will be back soon with Season#5 of the SGEM. It will include an exciting new feature for SGEMHOP from AEM. Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine. SGEM Xtra: Freeze Frame - Paper in a Pic [ 11:40 ] Play Now | Play in Popup |...
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Read MoreSGEM Xtra: Top 10 Emergency Department Tips for Families
Podcast Link: SGEM Xtra Top 10 List Date: July 5th, 2016 Guest Skeptic: Dr. Rodrick Lim. Rod is the Chair for the Pediatric section of the Canadian Association of Emergency Physicians, and the standards lead for the Pediatric section of International Federation for Emergency Medicine. He is an associate professor of Pediatrics at Western University, Schulich School of Medicine. Rod is also the proud father of three children and loves travelling, suffering as a Toronto sports fan and playing hockey badly with colleagues. This is a SGEM Xtra. Some extra content for the summer until we formally launch Season#5 this fall. The Pediatric Section of the Canadian Association of Emergency Physicians (CAEP) and the National Emergency Nurses Association (NENA) recently released some tips to keep your family safe and prepared. You can print a PDF of the Top 10 ED Tips for Families and stick on your fridge, talk to your children, share with your school, co-workers, neighbours and friends, and post to your social media accounts. It is available in ENGLISH and FRENCH. If you have any questions about this list please contact Dr. Lim at media@caep.ca Top 10 Emergency Department Tips for Families Listen to the podcast to hear Dr. Lim expand on each of these issues. #10 Vaccinate your children. There has been an unfortunate & unnecessary return of preventable diseases (e.g. measles, mumps, whooping cough) in Canada over the last few years. These illnesses always find a way into our EDs and our waiting rooms. Protect the very young & the very old in your community (who are the ones most at risk) by ensuring your children all get vaccinated. It’s the right thing to do and, quite simply, it saves lives. #9 Be a safety role model to your children and promote injury prevention. A really big part of keeping your child out of the ED in the first place is to teach them to make smart decisions about preventing injuries before they happen. Choosing to always wear a seatbelt, a helmet, and a life jacket is a good start. And PLEASE don’t text & drive – distraction is the #1 killer on the roads! These actions alone can save hundreds of lives across Canada EVERY year. #8 Promote healthy activities in your family. Healthy children & adults recover faster from the illnesses and injuries that bring them to the ED. It’s important to balance “screen time” with physical exercise; this applies to both your children and...
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Read MoreSGEM#159: Computer Games – Computer Provider Order Entry (CPOE)
Podcast Link: SGEM159 Date: July 5th, 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). Background: Emergency department crowding is a growing issue across Canada. As more tertiary care EDs implement computerized provider order entry (CPOE), it is important to analyze emergency department metrics to see how CPOE may impact throughput. Previous studies have shown that CPOE has no impact on mortality, and may in fact improve pain treatment and adherence to certain common presenting complaint medication protocols (such as stroke and renal colic) [1-4]. Some studies have shown there may be an impact on throughput in a number of possible areas such as decreased physician productivity, increased LOS for admitted patients, or increased time to order labs and imaging [5-7]. Other studies have shown that CPOE fixes some errors, creates new ones and frustrates physicians [8]. There is no consistent or comprehensive evidence in favor of CPOE [9]. A study looking at productivity in a community hospital emergency department showed the mean percentage of time spent on data entry was more than 40% and less than 30% spent on direct patient care. They calculated in a busy 10hr shift the number of mouse clicks was almost 4,000 [10]. To our knowledge there have been no studies to directly evaluate the impact of CPOE on emergency department wait times, a key variable in throughput and crowding. Question: What impact will CPOE have on emergency department patient throughput? Reference: Gray A et al. The impact of computerized provider order entry on emergency department flow. CJEM 2016. Population: Emergency department patients 18 years and older presenting to two quaternary hospitals in July and August of 2013 and 2014. Excluded: Patients with negative wait times or extreme outliers that exceeded 24 hours (presumed to represent an erroneously wrong day recorded). Also excluded any patients missing vital statistics (eg. Gender, age or CTAS score). Intervention: Computerized provider order entry (CPOE) Control: Non-computerized order entry Outcome: Primary Outcome: Emergency department throughput Wait Time (WT): Time to first physician assessment after triage (minutes) Length of Stay (LOS): Time to disposition after triage (minutes) Left Without Being Seen (LWBS): Proportion of patients that LWBS/total patients for a given time period (%) Secondary...
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Read MoreSGEM Xtra: RANThony #4 X-rays for Pediatric Constipation
Podcast Link: SGEM Xtra RANThony#4 Date: June 26th, 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 known on YouTube for his RANThony‘s. These are short rants on pediatric topics. They were inspired by the rants done by the great Canadian comedian Rick Mercer. Previous topics have included Fever Fear, Cough Medication and Pain Control. Anthony is also the creator of the evidence based medicine (EBM) education website SketchyEBM. These are white board videos that present EBM concepts in a creative and understandable formate. He covers topics like: Relative risk (RR), relative risk reduction (RRR), absolute risk reduction (ARR) What is bias? Confidence intervals and “p” values Number needed to treat (NNT) Intention to treat (ITT) analysis This fourth RANThony addresses the issue of x-rays for the diagnosis of pediatric constipation. Click on this LINK to watch the YouTube video and as Anthony says “always draw your own conclusions.” X-rays for Pediatric Constipation Introduction: Pediatric constipation is a common presentation to clinics, urgent care centers and emergency departments. The first step in management of pediatric constipation is making the appropriate diagnosis. Diagnosis: The NASPGHAN and ESPGHAN concluded in a 2014 guideline that “the diagnosis of functional constipation is based on history and physical examination” and that we use “the Rome III criteria for the definition of functional constipation for all age groups”. Radiography: A systematic review by Berger (2012) found that there was “insufficient evidence for a diagnostic association between clinical symptoms of constipation and fecal loading on abdominal radiographs”. The NASPGHAN and ESPGHAN guidelines state that “the routine use of an abdominal radiograph to diagnose functional constipation is not indicated”. Adverse effects: Aside from the risks of radiation exposure concern had been raised about whether performing xrays in children to diagnose constipation can be misleading. A paper by Freedman (2014) found that “misdiagnoses in children with constipation are more frequent in those in whom an AXR was performed”, that “the presence of stool on AXR does not rule out an alternative diagnosis.” Missed diagnoses included appendicitis, bowel obstruction and intussusception. Imagine Two Stories: A three year-old presents with a history of infrequent stools that are large caliber, painful and plug the toilet. The child has fecal soiling in between bowel movements. Is this child constipated? Yes. Does the child need an abdominal xray to help with this diagnosis? No. A four year-old presents with abdominal pain. Earlier in the...
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Read MoreSGEM#158: Tempted by the Fruit of Another – Dilute Apple Juice for Pediatric Dehydration
Podcast Link: SGEM158 Date: June 15th, 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 the creator of SketchyEBM. Case: A 2-year-old girl presents with a two-day history of vomiting and diarrhea. She is minimally dehydrated and tolerating oral fluid only. You remember reading about the sodium-glucose co-transporter and electrolyte fluids that were initially developed by the World Health Organization for children with diarrheal diseases. You have heard parents ask about just using watered down juice and debate whether this is a viable option for these children. Background: Gastroenteritis is a common illness in children and these children are at risk of dehydration from inadequate intake, excessive losses or both together. If children are unable to tolerate oral hydration we often have to use intravenous fluids and sometimes require admission to hospital for ongoing fluids. Goldman et al Pediatrics in 2008 published a helpful table describing the degree of dehydration in children ranging from mild, moderate to severe. Most cases of gastroenteritis are mild, self-limiting and can be treated effectively with oral rehydration. For more information on visit this site on Oral Rehydration Therapy. The Canadian Pediatric Society also has an algorithm for oral rehydration (see below). We covered ondansetron on SGEM#12. Bottom line – Ondansetron is an effective anti-emetic preventing further vomiting, intravenous fluids and admissions for children with gastroenteritis. NNT of 5 to stop vomiting NNT of 5 to prevent one intravenous insertion NNT of 14-17 to prevent one admission We also talked about ondansetron on SGEM#122. For the centers studied, the rates of ondansetron use increased from 0.1% to 42%. However, there was no significant difference in the rates of intravenous insertion or hospitalization during this time frame. Children with vomiting from gastroenteritis, and mild-moderate dehydration, should have a trial of oral rehydration therapy. Failing this, ondansetron should be administered. Failing that, intravenous fluid should be considered. Clinical Question: In children with mild gastroenteritis who are minimally dehydrated, is diluted apple juice and preferred fluids as good (or even better) an oral rehydration fluid compared to an electrolyte rehydration solution? Reference: Freedman et al. Effect of dilute apple juice and preferred fluids vs. electrolyte maintenance solution on treatment failure among children with mild gastroenteritis: A randomized clinical trial. JAMA. May 2016 Population: Children presenting to the emergency department between six months to five years age. They needed to have...
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Read MoreSGEM#157: Nebulized Hypertonic Saline for Acute Bronchiolitis
Podcast Link: SGEM157 Date: June 6th, 2016 Guest Skeptic: Dr. Chantal Guimont. Chantal is a Family Doctor who works in a in a mixed pediatric and adults tertiary care center in Quebec City. She has a PhD in epidemiology and is on faculty at Laval University. Case: You are working in the emergency department when an eight months old presents with nasal congestion, tachypnea, and retractions. You suspect he suffers from a acute bronchiolitis. You wonder about the most accurate and up to date treatment options. Background: During winter months in Quebec, and I suspect it is the same in many other places, bronchiolitis is one of the most frequent emergency department complaints. Bronchiolitis is the most common disease of the lower respiratory tract infection seen in children less than one year of age. They tend to present similar to an asthma exacerbation (coughing and wheezing). It is usually a mild illness needing only supportive care. However, it can be a more serious illness requiring hospitalization and rarely causes death. A good history and physical exam are sufficient to confirm the diagnosis. Treatment usually involves supportive care and supplemental oxygen if oxygen saturations are below 90%. Many treatments similar to those given to asthmatic children have been tried (example: beta-agonists, ipratropium, oral and inhaled steroids). These asthma treatments and antibiotics have been shown not to be effective for the treatment of bronchiolitis. 3% hypertonic saline (HS) is a newer treatment option. In theory, it rehydrates the respiratory tract, thins the epithelial edema and enhances secretion clearance. In 2013, Zhang and colleagues published a meta-analysis on acute bronchiolitis. In this systematic review, there were 1,090 children aged up to 24 months with mild to moderate viral bronchiolitis. According to their analyses, they concluded that even if a tendency to reduce hospital admission was observed, there was no statistical evidence of an effect of nebulized hypertonic saline on hospital admission. In November 2014, the American Academy of Pediatrics Clinical Practice Guidelines recommended that “Nebulized hypertonic saline should not be administered to infants with a diagnosis of bronchiolitis in the emergency department” (AAP 2014). Also in 2014, the Canadian Paediatric Society declared that “Evidence does not currently support its routine use in the outpatient setting” (CPS 2014) . In June 2015 the National Institute for Health and Care Excellence (NICE) put out their guidelines for the diagnosis and management of bronchiolitis. They too do not recommend hypertonic saline to treat children with bronchiolitis....
Most Recent Articles
SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes
Podcast Link: SGEM161 Date: September 21st, 2016 Reference: Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 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: A 49-year-old male presents to the emergency department after being in a motor vehicle collision. You diagnose him with an isolated sternal fracture on X-ray. Specifically there are no rib fractures or lung abnormalities identified. He also has a normal ECG and troponin. As you are preparing to discharge him, he asks if there are any potential complications to expect from the injury, and how long he should expect to have pain? Background: Sternal fractures are often the result of a significant blunt thoracic trauma and have an incidence between 0.33% of all trauma patients (Recinos et al and 3.7% of patients admitted after a motor vehicle accident (Yeh et al). Poor outcomes in patients with sternal fracture are associated with the severity of other injuries, complications and pre-existing comorbidities (Yeh et al). Many...
Read More
SGEM#160: Oh Baby, You’re Too Sensitive – High Sensitivity Troponin
Podcast Link: SGEM160 Date: September 8th, 2016 Reference: Body et al. The use of very low concentrations of high sensitivity troponin T to rule out acute myocardial infarction using a single blood test. AEM Sept 2016. 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. This is a SGEM Hot Off the Press episode. Here is a summary of the process but you can click on the SGEMHOP link for more details and previous episodes: A peer reviewed paper is selected pre-publication from AEM or CJEM that we think will be of interest to the SGEMers. We do a structured critical review of the paper using the quality check list developed by the Best Evidence in Emergency Medicine (BEEM) group. The paper is then discussed with one of the paper’s authors to give us a better understanding of the strengths and weaknesses of the paper. A blog and podcast are posted encouraging the FOAMed world to engage with us and the author over a one week period. A summary of the critical review and the best social media engagement is then published in AEM or CJEM to help cut that knowledge translation...
Read More
SGEM Xtra: Freeze Frame – Paper in a Pic
Podcast Link: SGEM Xtra PaperinaPic Date: September 1st, 2016 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. This is an SGEM Xtra summer content episode. But don’t panic we will be back later this month...
Read More
SGEM Xtra: Top 10 Emergency Department Tips for Families
Podcast Link: SGEM Xtra Top 10 List Date: July 5th, 2016 Guest Skeptic: Dr. Rodrick Lim. Rod is the Chair for the Pediatric section of the Canadian Association of Emergency Physicians, and the standards lead for the Pediatric section of International Federation for Emergency Medicine. He is an associate professor of Pediatrics at Western University, Schulich School of Medicine. Rod is also the proud father of three children and loves travelling, suffering as a Toronto sports fan and playing hockey badly...
Read More
SGEM#159: Computer Games – Computer Provider Order Entry (CPOE)
Podcast Link: SGEM159 Date: July 5th, 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). Background: Emergency department crowding is a growing issue across Canada. As more tertiary care EDs implement computerized provider order entry...
Read More
SGEM Xtra: RANThony #4 X-rays for Pediatric Constipation
Podcast Link: SGEM Xtra RANThony#4 Date: June 26th, 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 known on YouTube for his RANThony‘s. These are short rants on pediatric topics. They were inspired by the rants done by the great Canadian comedian Rick Mercer. Previous topics have included Fever Fear, Cough Medication and Pain Control. Anthony is also the...
Read More
SGEM#158: Tempted by the Fruit of Another – Dilute Apple Juice for Pediatric Dehydration
Podcast Link: SGEM158 Date: June 15th, 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 the creator of SketchyEBM. Case: A 2-year-old girl presents with a two-day history of vomiting and diarrhea. She is minimally dehydrated and tolerating oral fluid only. You remember reading about the sodium-glucose co-transporter and electrolyte fluids that were initially developed by the World...
Read More
SGEM#157: Nebulized Hypertonic Saline for Acute Bronchiolitis
Podcast Link: SGEM157 Date: June 6th, 2016 Guest Skeptic: Dr. Chantal Guimont. Chantal is a Family Doctor who works in a in a mixed pediatric and adults tertiary care center in Quebec City. She has a PhD in epidemiology and is on faculty at Laval University. Case: You are working in the emergency department when an eight months old presents with nasal congestion, tachypnea, and retractions. You suspect he suffers from a acute bronchiolitis. You wonder about the most accurate...
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SGEM#156: Working at the Abscess Wash – Irrigation of Cutaneous Abscesses?
Podcast Link: SGEM156 Date: May 25th, 2016 Guest Skeptic: Chip Lange is an emergency medicine Physician Assistant (PA) working primarily in rural Missouri community hospitals. He has international experience in critical care and emergency medicine. Currently, he is working on developing a new blog and podcast specifically for PAs in emergency medicine but wants all those who take care of critically ill or injured patients to be able to learn. Case: A 30-year-old female with a history of cutaneous abscesses comes...
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SGEM#155: Girls Just Want To Have Fun – Not Appendicitis
Podcast Link: SGEM155 Date: May 24th, 2016 Guest Skeptics: 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 the creator of SketchyEBM. Case: A 15-year-old female patient presents to your emergency department with a chief compliant of abdominal pain. A medical student picks up the chart and comes back to tell you about the case. His presentation includes that the abdominal...
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SGEM#154: Here I Go Again, Kidney Stone
Podcast Link: SGEM154 Date: May 12th, 2016 Guest Skeptics: Dr. Tony Seupaul and Dr. Marc Phan. Tony is the Chairman of the Department of Emergency Medicine, University of Arkansas. Marc is a PGY-3 resident in the Emergency Medicine program at the University of Arkansas. Case: 48 year old man presents to the emergency department complaining of right flank pain radiating to his groin. He states the pain comes in “waves,” and he has associated nausea without vomiting. On exam, he is afebrile...
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SGEM#153: Simulation for Ultrasound Education
Podcast Link: SGEM153 Date: May 2nd, 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 highlight 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: An emergency medicine resident in your institution has learned some basics of ultrasound training, but feels uncomfortable performing ultrasound...
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