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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#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#146: The HEAT is On – IV Acetaminophen for Fever in the ICU

Posted by on Feb 7, 2016 in Featured, Infectious, Podcasts | 4 comments

Podcast Link: SGEM146 Date: February 2nd, 2016 Guest Skeptic: Dr. Justin Morgenstern. Justin is an emergency physician and the director of simulation education at Markham Stouffville Hospital in Ontario. He loves skepticism and medical education, especially when it is free and open access. He is the author of the #FOAMed blog First10EM.com and is an associate editor of Emergency Medicine Cases. Case: A 64-year-old woman presents to the emergency department with fever, urinary symptoms, and altered mental status. You diagnose her with sepsis with a probable urinary source. You rapidly provide empiric antibiotics and initiate fluid resuscitation. You are ready to send her up to the ICU for monitoring when your nurse asks, “shouldn’t we give her some acetaminophen for her fever?” Background: If you work in emergency medicine, you are aware of the continuous debate about fever. Is it harmful? Is it helpful? Should...

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SGEM#131: Gimme Some Antibiotics for Uncomplicated Skin Infections

Posted by on Oct 11, 2015 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM131 Date: October 8th, 2015 Case: A 26-year-old male presents to your emergency department with complaints of a painful, reddened area on his right arm. He has no significant past medical history, surgical history, or social history, but reports that he has an allergic reaction to penicillin and cephalosporin antibiotics. On exam, you find an abscess approximately 6cm in diameter with surrounding cellulitis. After performing an incision and drainage, you contemplate sending the patient home with a prescription for antibiotic therapy. The patient expresses to you that he’s seen cases of MRSA (methicillin-resistant Staphylococcus aureus) reported on the news and is worried this may be involved in his infection.  Background: Skin and soft tissue infections (SSTIs) are a common reason for visits to the emergency department, hospital admissions, and may result in considerable morbidity and mortality. Classically, it...

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SGEM#120: One Thing or Two for Community Acquired Pneumonia?

Posted by on May 17, 2015 in Featured, Infectious, Podcasts, Pulmonary | 0 comments

Podcast Link: SGEM120 Date: May 7th, 2015 Guest Skeptics: Victor Tsang graduated from University of Waterloo School of Pharmacy and is currently doing a residency at London Health Sciences Centre in London, Ontario. Cassandra McEwan graduate of McGill University and University of Waterloo. She is also completing a residency program at London Health Sciences Centre. Case: 62 year old man presents to your emergency department with a four day history of increasing shortness of breath, purulent cough, fever, and generally feeling quite unwell. You measure her vitals, and he is mildly tachycardic and tachypneic, normotensive, O2 Sats are 96% on room air and his temperature is 38.2C. You obtain routine blood work including a lactate level and blood cultures. A chest x-ray reveals a left lower lobe infiltrate in his lungs suggestive of pneumonia, and the decision is made to admit...

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