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SGEM#164: Cuts Like a Knife – But you Might Also Need Antibiotics for Uncomplicated Skin Abscesses

Posted by on Oct 17, 2016 in Dermatologic, Featured, Infectious, Podcasts | 4 comments

Podcast Link: SGEM164 Date: October 13th, 2016 Reference: Talan et al. Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. NEJM March 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 has a new blog called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. He has recently started podcasting and is always looking to expand this new project. He cares about providing TOTAL care everywhere and wants us all to be excellent when we see and treat out patients. Case: A 40 year-old male with a history of MRSA presents complaining of an area of redness and swelling consistent with an abscess developing on his arm. He says that he has heard that antibiotics may not...

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SGEM#163: Shuffle off to Buffalo to Talk Thrombolysis for Acute Pulmonary Embolism

Posted by on Oct 10, 2016 in Cardiac, Featured, Podcasts, Pulmonary | 2 comments

Podcast Link: SGEM163 Date: October 6th, 2016 Reference: Piazza et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism. JACC 2015 Guest Skeptic: Dr. Essie Reed is one of the Chief Residents in the Department of Emergency Medicine at the University of Buffalo. Case: A 75-year-old female with a past medical history of hypertension and non-insulin dependent diabetes presents with chest pain. She describes the pain as sharp, stabbing, and exacerbated with deep inspiration. She reports associated shortness of breath. She denies syncope, nausea, and diaphoresis. The pain has been present for one week, and is nearly constant. She reports that she traveled to Florida to visit her grandchildren three weeks ago. She has no fever, chills, cough, or sputum production. She is complaining of ongoing chest pain, 5/10, increased to 7/10 when asked...

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SGEM#162: Not Stayin’ Alive More Often with Amiodarone or Lidocaine in OHCA

Posted by on Oct 2, 2016 in Cardiac, Featured, Podcasts | 2 comments

Podcast Link: SGEM162 Date: September 29th, 2016 Reference: Kudenchuk et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. NEJM April 2016 Guest Skeptic: Dr. Rory Spiegel is a clinical instructor at University of Maryland and a recent graduate of Stony Brook’s Resuscitation Fellowship. He writes an excellent blog called EM Nerd, which he describes as nihilistic ramblings. Case: Your local EMS agency has asked your opinion on which anti-arrhythmic medication, if any, their ambulances should stock for the management of ventricular fibrillation or pulseless ventricular tachycardia refractory to defibrillation. Additionally, they want to know how best to incorporate these agents into their current resuscitation protocol? Background: The American Heart Association estimates there are about 350,000 EMS-assessed out-of-hospital cardiac arrests in the United States each year. Half of these arrests are witnessed with the other half being un-witnessed. Many out-of-hospital cardiac arrests...

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SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes

Posted by on Sep 25, 2016 in Featured, Podcasts, Pulmonary, Trauma | 9 comments

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...

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SGEM#160: Oh Baby, You’re Too Sensitive – High Sensitivity Troponin

Posted by on Sep 12, 2016 in Cardiac, Featured, Podcasts | 25 comments

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 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...

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