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SGEM#220: Acupuncture vs. Morphine for Renal Colic

Posted by on May 26, 2018 in Featured, Genitourinary, Podcasts | 0 comments

Podcast Link: SGEM220 Date: May 16th, 2018 Reference: Beltaief K et al. Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial. J Pain Res. 2018 Guest Skeptic: Dr. Tony Seupaul  is the Chairman of the Department of Emergency Medicine, University of Arkansas. Dr. Cordell Cunningham is a PGY 2 in Emergency Medicine at University of Arkansas for Medical Sciences Case: A 51-year-old man presents to the emergency department complaining of right flank pain radiating to his groin like his previous episodes of renal colic. He states the pain comes in “waves,” is associated with nausea but no vomiting. On exam, he is afebrile and appears very uncomfortable while grabbing his right flank. He has used ketorolac, acetaminophen and tamsulosin in the past. He really wants to avoid taking any opioids and is wondering if acupuncture could work? Background: We have covered renal colic...

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SGEM#205: Twist & Shout – Testicular Torsion

Posted by on Feb 3, 2018 in Featured, Genitourinary, Podcasts | 7 comments

Podcast Link: SGEM205 Date: January 31st, 2018 Reference: Frohlich LC, et al. Prospective validation of clinical score for males presenting with an acute scrotum. AEM Dec 2017. Guest Skeptic: Dr. Melissa Langhan is an Associate Professor of Pediatric Emergency Medicine at Yale University in New Haven, CT. Melissa is passionate about clinical and translational research and focuses most of her work on the use of capnography or end-tidal carbon dioxide monitoring. In her spare time, Melissa also enjoys being the fellowship director to an amazing group of PEM trainees.    Case: Brian is a 14-year-old male who presents to the emergency department (ED) complaining of acute onset testicular pain. He has vomited twice, but there is no history of any fever or trauma. On examination, you find a firm, swollen right testicle, and the cremasteric reflex is notably absent on that side. Your index of...

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SGEM#202: Lidocaine for Renal Colic?

Posted by on Jan 14, 2018 in Featured, Genitourinary, Podcasts | 10 comments

Podcast Link: SGEM202 Lidocaine Date: January 9th, 2018 Reference: Soleimanpour H et al. Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department. Urology 2012 Guest Skeptics: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine at the University of Arkansas. Dr. Rachel Littlefield is a PGY2 in Emergency Medicine at the University of Arkansas. Knowledge Translation Window: A short note to point out that this paper was not published in the last year. However, it is less than ten years old so we are cutting the KT window down to less than ten years. It was selected because there has been a number of people on Facebook and Twitter talking about using lidocaine to treat renal colic. Of course we were skeptical and wanted to review the evidence. Case: A 45-year-old male presents to the emergency department with...

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SGEM#190: Wee are the Champions of Pediatric Urine Samples

Posted by on Oct 1, 2017 in Featured, Genitourinary, Infectious, Pediatrics, Podcasts | 4 comments

Podcast Link: SGEM190 Date: September 26th, 2017 Reference: Kaufman, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ April 17. Guest Skeptic: Dr. Natalie May trained as an emergency physician with subspecialty paediatric emergency medicine in the UK and worked in Manchester and Oxford before moving to Australia in 2015 to work for Sydney HEMS. She’s been there for the last 18 months working in prehospital and retrieval medicine and then in Emergency Medicine. She is a medical education enthusiast and has been an editor and regular contributor to the St. Emlyn’s blog and podcast since 2012. We appeared on stage at SMACC Chicago doing a parody of Jimmy Fallon’s Tight Pants skit. Case: You are working the afternoon shift in the paediatric emergency department. It has been the usual busy after-school, after-work time. Your shift is...

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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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SGEM#71: Like a Rolling Kidney Stone (A Systematic Review of Renal Colic)

Posted by on Apr 19, 2014 in Featured, Genitourinary, Podcasts | 1 comment

Podcast Link: SGEM71 Date:  April 11, 2014  Guest Skeptics: Dr. Anthony (Tony) Seupaul Chairman of the Department of Emergency Medicine, University of Arkansas for Medical Sciences and Dr. Joshua Hughes one of his star residents. Case Scenario: A 36 yr old previously healthy white male that comes into the emergency department mid morning one Sunday after about 10 hours of right flank pain he describes as sharp/stabbing and that has progressively become worse since onset. He says that over the last couple of hours he has felt that it is radiating down towards his groin. He has been “sick to his stomach” but has not vomited. He denies seeing any blood in his urine and has not experienced any pain with urination. He denies any diarrhea. He has not had any fever that he knows of. He denies any previous pain like...

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