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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 | 2 comments

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#144: That Smell of Isopropyl Alcohol for Nausea in the Emergency Department

Posted by on Jan 24, 2016 in Featured, GastroIntestinal, Podcasts | 6 comments

Podcast Link: SGEM144 Date: January 20th, 2016 Guest Skeptic: Meghan Groth (@EMPharmGirl). Meghan is the emergency medicine pharmacy specialist at the University of Vermont Medical Center, and an adjunct professor of pharmacy at the Albany College of Pharmacy and Health Sciences. Case: A 34-year-old male presents to your emergency department with complaints of severe nausea for the past 24 hours. He’s vomited a number of times at home and on a scale of zero to ten (ten being the worst nausea he’s ever experienced), he rates his current nausea at an eight. As the triage nurse brings him back to get settled into his room, you observe him holding an emesis basin and dry heaving. He has no significant past medical history and no known drug allergies. Background: Nausea and vomiting is a very common complaint for patients presenting to the...

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SGEM#139: One Thing Leads to Another – Idarucizumab for Dabigatran Reversal?

Posted by on Dec 6, 2015 in Featured, GastroIntestinal, Hematologic, Podcasts | 4 comments

Podcast Link: SGEM139 Date: December 3rd, 2015 Guest Skeptics: Dr. Ryan Radecki is Clinical Practice Lead at Kaiser Permanente North West and Clinical Assistant Professor of Emergency Medicine – The University of Texas Medical School at Houston. He has a blog called Emergency Medicine Literature of Note.   Case: A 67-year-old man presents with a history of atrial fibrillation and hypertension. He takes metoprolol 50mg twice daily and dabigatran 150mg twice daily. He had been having mild epigastric pain for about one week and had one episode of coffee ground emesis that night. He arrives via ambulance with a blood pressure of 120/70, heart rate of 74 beats per minute and O2 saturation of 98% on room air. Background: Dabigatran is a non-vitamin K antagonist anticoagulant that works by inhibiting thrombin. It is approved for the prevention and treatment of venous thromboembolism....

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SGEM#117: Diarrhea – Hard to Spell, Easy to Smell and Easy to Cause with IV Antibiotics

Posted by on Apr 26, 2015 in Featured, GastroIntestinal, Infectious, Podcasts | 3 comments

Podcast Link: SGEM117 Date: April 24th, 2015 Guest Skeptics: Meghan Groth (@EMPharmGirl). Meghan is the emergency medicine pharmacy specialist at the University of Vermont Medical Center in Burlington, Vermont and an adjunct professor of pharmacy at the Albany College of Pharmacy and Health Sciences. Case: A 58 year old male presents to your emergency department complaining of a warm, painful, reddened area on his left thigh. His past medical history is only significant for generalized anxiety disorder and he has no known drug allergies. On exam, you find no evidence of an abscess, and you find his labs and vital signs are within normal limits. You confidently give him a diagnosis of uncomplicated cellulitis and need to determine an antibiotic regimen. You’d like to send him home with a five day course of cephalexin, but are thinking about giving him an intravenous (IV) dose...

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SGEM#115: Complicated – Non-Operative Treatment of Appendicitis (NOTA)

Posted by on Apr 12, 2015 in Featured, GastroIntestinal, Podcasts | 0 comments

Podcast Link: SGEM115 Date: April 11th, 2015 Guest Skeptics: Dr. Bret Batchelor. Bret is a general practitioner with Enhanced Surgical Skills currently working in Vanderhoof, BC. He is the host of the newly created podcast that can be found on iTunes called Really Rural Surgery. Case: A 35 year-old man presents to the emergency room with right lower quadrant pain for approximately 18 hours. You assess the patient and find that his Alvarado Score is 7. You then ask for an ultrasound, as his body mass index is in the normal range. The ultrasound shows that he has an enlarged appendix >6mm that is not compressible and there is no intraperitoneal fluid present. You make a presumptive diagnosis of uncomplicated acute appendicitis. You relay this finding to the patient and he turns to you and asks, “Hey doc, I heard that...

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