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SGEM#174: Don’t Believe the Hype – Vitamin C Cocktail for Sepsis

Posted by on Apr 9, 2017 in Featured, Infectious, Podcasts | 5 comments

Podcast Link: SGEM174 Date: April 6th, 2017 Reference: Marik et al. Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest Dec 2016 Guest Skeptic: Dr. Jeremy Faust is an attending emergency physician at Brigham and Women’s Hospital in Boston Massachusetts and an instructor at Harvard Medical School. He’s the co-host of FOAMcast with co-host Dr. Lauren Westafer and he’s written about sepsis in the Annals of Emergency Medicine, EM Clinics of North America, and for mainstream audiences in Slate.  Case: A 60 year-old man is admitted to the ICU with severe sepsis from pneumonia. He has a history of hypertension and diabetes. You are providing him with intravenous fluids and appropriate antibiotics. When speaking with the family his son asks about a vitamin C cure he just read about? Background: We have covered...

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SGEM#171: Step-by-Step Approach to the Febrile Infant

Posted by on Mar 12, 2017 in Featured, Infectious, Pediatrics, Podcasts | 6 comments

Podcast Link: SGEM171 Date: February 27th, 2017 Reference: Gomez et al. Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Pediatrics 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 also the creator of SketchyEBM. Case: A 25-day-old girl presents with fever. There is no history of congestion, cough, vomiting, diarrhea, shortness of breath or any other focus for her infection. She looks well on exam and her vitals are normal except for a rectal temperature of 38.3C. She is less than 28 days old and you wonder how much of a work up to do (full septic workup, intravenous antibioticsadmission to hospital, blood and urine tests)? Background: Fever without source in infants less than three months old...

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SGEM#168: HYPRESS – Doesn’t Got the Power

Posted by on Jan 22, 2017 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM168 Date: January 19th, 2017 Reference: Keh D et al. Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis: The HYPRESS Randomized clinical Trial. JAMA 2016. Guest Skeptic: Salim Rezaie is a faculty physician at Greater San Antonio Emergency Physicians (GSEP) in San Antonio, Texas. He is the founder and creator of REBEL EM and REBEL Cast as well as the co-creator and co-founder of the Teaching Institute, a medical education startup company trying to change the world of medical education.  Case: A 66-year-old female comes to the emergency department with fever and cough. She has a past medical history of diabetes mellitus, hypertension, and hyperlipidemia. Initial vital signs show a blood pressure of 154/87 mmHg, heart rate 132 beats per minute, respiratory rate 28 breaths per minute, oxygen saturation of 94% on room air, and an...

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SGEM#167: The Management of Bronchiolitis in Community Hospitals

Posted by on Dec 18, 2016 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 12 comments

Podcast Link: SGEM167 Date: December 14th, 2016 Reference: Plint et al. Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study. CJEM November 2016 Guest Skeptic: Dr. Chris Bond. Chris is an emergency physician and clinical lecturer at the University of Calgary. He is currently the host of CAEP Casts, which highlights educational innovations from emergency medicine residency programs across Canada. Chris also has his own #FOAMed blog called Standing on the Corner Minding My Own Business (SOCMOB). Case: Parents present to your community emergency department with their 6-month-old daughter. She has had a cough, fever, and “noisy breathing” for the past 24 hours. She is otherwise healthy, having had a previously uncomplicated prenatal, delivery, and post-natal course. Her immunizations are up to date. There is no family history of atopy or asthma. On exam she is febrile at...

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SGEM#164: Cuts Like a Knife – But you Might Also Need Antibiotics for Uncomplicated Skin Abscesses

Posted by on Oct 17, 2016 in Dermatologic, Featured, Infectious, Podcasts | 4 comments

Podcast Link: SGEM164 Date: October 13th, 2016 Reference: Talan et al. Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. NEJM March 2016 Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant working primarily in rural Missouri in community hospitals. He has international experience in critical care and emergency medicine. He has a new blog called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. He has recently started podcasting and is always looking to expand this new project. He cares about providing TOTAL care everywhere and wants us all to be excellent when we see and treat out patients. Case: A 40 year-old male with a history of MRSA presents complaining of an area of redness and swelling consistent with an abscess developing on his arm. He says that he has heard that antibiotics may not...

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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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