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SGEM Xtra: CALS Conference on Rural Emergency Care

Posted by on Sep 30, 2017 in Conferences, Featured, Podcasts | 0 comments

Date: Sept 30th, 2017 I had the pleasure of presenting at the CALS Conference on Rural Emergency Care held in beautiful Minneapolis, Minnesota yesterday.  Thank you to Dr. Todd Grant and the conference committee for inviting me. Everyone made me feel very welcome. The keynote address was called Looking Back/Looking Ahead. I was asked to look back over my career providing rural emergency care and look ahead to the future of rural emergency care. There were five objectives to the presentation: 1) Define Evidence Based Medicine (EBM): “The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”  (David Sackett et al BMJ 1996). The evidence based medicine triad can be illustrated in a Venn diagram. EBM encourages the health care professionals to use their clinical judgment. It also includes the patients values and preferences. The third part of the...

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SGEM#189: Bring Me To Life in OHCA

Posted by on Sep 24, 2017 in Cardiac, Featured, Podcasts | 9 comments

Podcast Link: SGEM189 Date: September 19th, 2017 Reference: Cournoyer et al. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. September 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the AAEM MedEdPORTAL. Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. Background: There are about ½ million sudden cardiac arrests in the USA each year. About half of these cardiac arrests are OHCA and the survival rate is pretty poor. We have covered the topic of OHCA on the SGEM...

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SGEM#188: Icatibant Bites the Dust – For ACE-I Induced Angioedema

Posted by on Sep 17, 2017 in Featured, Podcasts | 2 comments

Podcast Link: SGEM188 Date: September 12th, 2017 Reference: Sinert et al. Randomized Trial of Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Upper Airway Angioedema. J Allergy Clin Immunol Pract 2017. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of Emergency Medicine at NYU/Bellevue Hospital in the Department of Emergency Medicine. He is also part of REBEL EM, The Teaching Course, EMRAP and CoreEM.  Case: As you walk in to your shift, the nurses grab you and bring you in to bed four where a patient has just presented with tongue swelling. In the room is a 53-year-old woman who, though, not in any particular distress, has got a swollen tongue and lower lip. After a bit of history, you find out that she is taking lisinopril and you determine that this is likely angiotensin converting enzyme inhibitor (ACE-I) induced angioedema. The patient’s swelling...

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SGEM Xtra: Stronger – Esther Choo

Posted by on Sep 15, 2017 in Featured, Podcasts | 0 comments

Podcast Link: SGEM Xtra Esther Choo Date: September 11th, 2017 Guest Skeptic: Dr. Esther Choo is an emergency physician and researcher who studies health disparities, substance use disorders, and gender bias. She obtained her MD from Yale University, did her clinical training at Yale-New Haven Hospital and Boston Medical Center, and completed a health services research fellowship at Oregon Health & Sciences University. This is an SGEM Xtra so we will not be doing a structured critical review of a recent paper trying to cut the knowledge translation window down for over ten years to less than one year using the power of social media. The next episode of the SGEM will be a formal critical appraisal of a recent publication. Esther recently sent shockwaves through the twitterverse with a series of tweets after the incident in Charlottesville. I reached out to Esther...

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SGEM#187: Pin Cushion – Acupuncture in the Emergency Department

Posted by on Sep 10, 2017 in Featured, Musculoskeletal, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM187a Date: September 7th, 2017 Reference: Cohen et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. MJA 2017 Guest Skeptic: Dr. Alfred Sacchetti is a full time practicing Emergency Physician, who is also the Chief of Emergency Medicine at Our Lady of Lourdes Medical Center in Camden, New Jersey, USA, an Assistant Clinical Professor of Emergency Medicine and an Active Researcher.   In addition, Dr. Sacchetti is one of the few individuals to have lectured on the same panel with Dr. Milne and survived with his sanity and reputation intact. Case: A 41-year-old man presents to the emergency department with an acute onset of back pain. He was putting some groceries into the car and felt something pull in his lower back.  He has no “red flags” on your history and physical examination. He is worried about...

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