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SGEM#180: The First Cut is the Deepest – N.O.T. for Paediatric Appendicitis

Posted by on May 28, 2017 in Featured, Pediatrics, Podcasts | 1 comment

Podcast Link: SGEM180 Date: May 24th, 2017 Reference: Georgiou et al. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Pediatrics 2017. Guest Skeptic: Dr. Ross Fisher is a Paediatric Surgeon in Sheffield, England. When he is not waxing lyrical about presentation skills (P Cubed) over at ffolliet.com, giving the Greatest Presentation in the World at SMACC or expounding his views on paediatric trauma management he can be found at Sheffield Children’s Hospital principally dealing with surgical oncology, vascular access and all sorts of neonatal surgical problems. Case: It is 7pm on a quiet evening in the emergency department and Bobby comes in. He’s 12 years old and complains of a belly ache, pointing to his right iliac fossa pain. It has been going on for about 36 hours now, initially peri-umbilical and associated with nausea, poor appetite and malaise.  It has increased...

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SGEM#179: Chase the Dragon and Naloxone

Posted by on May 21, 2017 in Featured, Pharmacology/Toxicology, Podcasts, Pulmonary | 2 comments

Podcast Link: SGEM179 Date: May 19th, 2017 Reference: Willman et al. Do heroin overdose patients require observation after receiving naloxone? Clinical Toxicology 2017. Guest Skeptic: Dr. Richard Hamilton (@RJHamiltonMD) is Chair of the Department of Emergency Medicine at Drexel University College of Medicine. He is also the host of EMToxCast and gave a talk at the Association of Academic Chairs of Emergency Medicine Annual Retreat called: Can Social Media Save Emergency Medicine? Case: A 45-year-old male arrives via emergency medical services (EMS) complaining that he wants to be discharged. EMS states they found him unresponsive and with paraphernalia consistent with intravenous heroin use. His prehospital vital signs were oxygen saturation of 89% and respiratory rate of six breaths per minute prior to administration of oxygen and 1 mg of naloxone. After naloxone administration he is alert and oriented times three with a normal pulse oximetry and clear lung fields....

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SGEM#178: Mindfulness – It’s not Better to Burnout than it is to Rust

Posted by on May 14, 2017 in Featured, Podcasts, Psychiatric | 4 comments

Podcast Link: SGEM178 Date: May 12th, 2017 Reference: Ireland et al. A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher 2017. Guest Skeptic: Dr. Diane Birnbaumer is a Senior Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is also an Emeritus Professor of Medicine at the David Geffen School of Medicine at UCLA. Case: A resident comes to you looking for advice. He is having trouble feeling tired, short-tempered and it is affecting his work interactions and personal sense of satisfaction with his job. You suspect he is suffering from early burnout. Background: Burnout is certainly a hot topic, and mindfulness has hit the front pages of the New York Times and Time Magazine, putting it front and center in the public eye. Burnout was a term coined by Herbert Freudenberger in 1974 (1). There are...

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SGEM#177: POCUS – A New Sensation for Diagnosing Pediatric Fractures

Posted by on May 7, 2017 in Featured, Musculoskeletal, Pediatrics, Podcasts | 38 comments

Podcast Link: SGEM177 Date: May 1st, 2017 Reference: Poonai et al. Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 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 SGEM HOP: This is another SGEM Hot Off the Press with Academic Emergency Medicine. Here is a reminder of how this special edition of the SGEM works: A paper that has been submitted, peer-reviewd, and accepted for publication in AEM is selected. The SGEM puts its skeptical eye upon the manuscript using the modified BEEM critical appraisal tool. One of the authors is invited to discuss their work on the SGEM podcast. A special SGEM Hot Off the Press blog is posted...

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SGEM#176: Somebody’s Watching Me – Cardiac Monitoring for Chest Pain

Posted by on Apr 30, 2017 in Cardiac, Featured, Podcasts | 2 comments

Podcast Link: SGEM176 Date: April 26th, 2017 Reference: Syed et al. Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring. CMAJ Jan 2017 Guest Skeptics: Drs. Ryan Tam and Antony Robert are chief residents from the Royal College Emergency Medicine Program at McGill University. Ryan Tam’s academic interests include quality improvement, ultrasound and simulation. He is also involved with a start-up FOAMed site called EM-bites focused on providing point of care resources. When he is not working, he is an enthusiastic photographer, foodie and adventure traveler. Antony Robert’s academic interests include resuscitation, medical education, research, ultrasound and medical informatics. He is also the CEO of a new medical education start up, and is currently working on the first prototype. When he is not working, he...

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SGEM#175: Dancing on the Ceiling with Ketorolac for Pain

Posted by on Apr 23, 2017 in Featured, Podcasts | 10 comments

Podcast Link: SGEM175 Date: April 20th, 2017 Reference: Motov et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med Dec 2016 Guest Skeptic: Dr. Ken Milne is a front line community emergency medicine physician passionate about skepticism, evidence based medicine and knowledge translation. He is also the moderator for Emergency Medical Abstracts, faculty member of Best Evidence in Emergency Medicine and creator of the Skeptics’ Guide to Emergency Medicine. Case: A 37-year-old, presents to the emergency department with sudden onset right-sided flank pain, hematuria and vomiting. He rates his pain as 8/10 and is writhing around on the stretcher. He says it feels like his previous kidney stones. His vital signs are within normal limits. You perform a quick bedside ultrasound, which reveals a normal aorta and...

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