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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 | 0 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 in rural and remote settings, his goal has been to help others provide total care everywhere. Case: A 68 year-old female arrives via EMS for left sided weakness starting two hours prior to arrival in the emergency department. She does not take blood thinners and has lived independently prior to her complaint today. Her head CT without contrast demonstrates a...

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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 for her infection. She looks well on exam and her vitals are normal except for a rectal temperature of 38.3C. She is less than 28 days old and you wonder how much of a work up to do (full septic workup, intravenous antibioticsadmission to hospital, blood and urine tests)? Background: Fever without source in infants less than three months old...

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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 of congestive heart failure, hypertension, and hyperlipidemia presents to the emergency department with a three-day history of shortness of breath on exertion, orthopnea and mild leg edema, but with normal vital signs. Her renal function is normal and troponin is negative. Her ECG is normal. After a dose of intravenous furosemide, she says she feels a lot better and would...

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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 | 3 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 with difficulty swallowing. He was enjoying a feast of corned beef and cabbage several hours prior to arrival when he said it felt like “something got stuck” in his throat. He does have a history of esophageal strictures, and this has happened to him before but he thought if he washed the food down with enough Guinness he wouldn’t have...

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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 world of medical education.  Case: A 66-year-old female comes to the emergency department with fever and cough. She has a past medical history of diabetes mellitus, hypertension, and hyperlipidemia. Initial vital signs show a blood pressure of 154/87 mmHg, heart rate 132 beats per minute, respiratory rate 28 breaths per minute, oxygen saturation of 94% on room air, and an...

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