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SGEM#238: The Epi Don’t Work for OHCA

Posted by on Dec 7, 2018 in Cardiac, Featured, Podcasts | 0 comments Play in new window | DownloadDate: December 6th , 2018 Reference: Perkins et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. NEJM 2018. 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: A 51-year-old man experiences a cardiac arrest on the street. You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation. He is unsuccessfully shocked. An oral airway is placed, peripheral intravenous (IV) line started successfully and the paramedic asks her partner if you want to administer IV epinephrine? Background: The AHA has five steps in the Chain-of-Survival for out-of-hospital cardiac arrest (OHCA). Step One– Recognition and activation of 911 Step Two–...

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SGEM Xtra: On the Edge of Burnout ACEM18

Posted by on Nov 24, 2018 in Podcasts | 0 comments Play in new window | Download Date: November 24th, 2018 As you may know, I was invited to give a keynote address on burnout at the Australasia College of Emergency Medicine 2018 Annual Scientific Meeting (#ACEM18) in Perth, Australia. This turned out to be a very meta event. A few months leading up to the presentation my dad, Dr. Ken Milne Sr. got seriously ill. While he faced this with his usual grace and dignity, I was living on the edge of burnout. He was admitted to hospital shortly before I was scheduled to leave for Australia. We had a number of discussions and he insisted that I go and not cancel the trip. We reviewed my keynote presentation in the hospital and he gave me the thumbs up. He was very proud and was telling all his treating...

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SGEM#237: Screening Tool for Child Sex Trafficking

Posted by on Nov 16, 2018 in Featured, Podcasts | 0 comments Play in new window | Download Date: November 10th , 2018 Reference: Kaltiso et al. Evaluation of a Screening Tool for Child Sex Trafficking Among Patients with High-Risk Chief Complaints in a Pediatric Emergency Department. AEM October 2018. Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and clinical lecturer in Calgary. He is also an avid FOAM supporter/producer through various online outlets including TheSGEM. You may have noticed there was no music for the introduction. Part of the SGEM brand is to have some fun and engaging theme music to help with knowledge translation. This topic of child sex trafficking is very serious and disturbing. I struggled with what would be an appropriate song choice. After thinking about it and not coming up with something acceptable I went to twitter to ask my #FOAMed friends. It was Minh...

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SGEM#236: TXA – Not for Brain Bleeds

Posted by on Nov 7, 2018 in Hematologic, Neurologic, Podcasts | 0 comments Play in new window | Download Date: November 6th , 2018 Reference: Sprigg et al. Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet. 2018 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s eighth visit to the SGEM. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force. Case: Your next patient is a stroke alert for a 67-year-old male living at a nursing home presents with severe right sided upper and lower extremity weakness noticed one hour ago while eating a meal.  He obtains a stat head CT which shows an intracerebral hemorrhage.  In addition to controlling his elevated blood pressure, you wonder if there is more you can offer this patient to...

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SGEM#235: Edoxaban for Cancer Associated VTE – Would the NEJM Lie to You?

Posted by on Oct 31, 2018 in Featured, Hematologic, Podcasts | 0 comments Play in new window | Download Date: October 30th , 2018 Reference: Raskob GE et al. Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism. NEJM 2018 Guest Skeptic: Dr. Anand Swaminathan is an assistant professor of Emergency Medicine at the St. Joseph’s Regional Medical Center in Patterson, NJ. He is a deputy editor for EM: RAP and, associate editor for REBEL EM. Case: A 43-year old woman with a history of breast cancer currently undergoing chemotherapy presents with mild chest pain. She is hemodynamically stable except for a heart rate of 105 and her pain is increased when she takes a deep breath. The chest x-ray is unremarkable, and you order a CT pulmonary angiogram (CTPA) which demonstrates a right segmental pulmonary embolism. You write a prescription for low molecular weight heparin (LMWH) and advise the patient that she will...

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