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SGEM Xtra: RANThony #4 X-rays for Pediatric Constipation

Posted by on Jun 26, 2016 in Featured, GastroIntestinal, Pediatrics, Podcasts | 0 comments

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...

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SGEM#158: Tempted by the Fruit of Another – Dilute Apple Juice for Pediatric Dehydration

Posted by on Jun 19, 2016 in Featured, GastroIntestinal, Infectious, Pediatrics, Podcasts | 1 comment

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...

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SGEM#157: Nebulized Hypertonic Saline for Acute Bronchiolitis

Posted by on Jun 12, 2016 in Featured, Pediatrics, Podcasts | 1 comment

 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...

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SGEM#156: Working at the Abscess Wash – Irrigation of Cutaneous Abscesses?

Posted by on Jun 5, 2016 in Featured, Infectious, Podcasts | 2 comments

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 to your emergency department stating she thinks she has another one developing on her arm. She tells you she wants to do as little as possible to treat the abscess using an incision and drainage because she hates the pain from the procedure, especially the irrigation. Background: Cutaneous abscesses are a very common complaint in the emergency department and there is...

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SGEM#155: Girls Just Want To Have Fun – Not Appendicitis

Posted by on May 29, 2016 in Featured, Infectious, Pediatrics, Podcasts | 13 comments

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 pain has been going on for two days, has worsened over this time period, and is worse in the right lower quadrant from previously being around her umbilicus. She had a temperature this morning of 101 degrees Fahrenheit, vomited twice this morning (non-billious, non-bloody), says the bumps in the road travelling to your hospital hurt badly, and she doesn’t want to...

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SGEM#154: Here I Go Again, Kidney Stone

Posted by on May 15, 2016 in Featured, Genitourinary, Podcasts | 4 comments

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 and appears very uncomfortable while grabbing his right flank. Background: We have covered renal colic a number of times on the SGEM. The last time it was a systematic review on tamsulosin from 2012. The SGEM Bottom Line from that episode was: “Tamsulosin is useless in most ED patients with ureteral colic unless their stone size exceeds at least 4mm.”...

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