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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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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#113: EGDT – ProMISe(s) ProMISe(s)

Posted by on Mar 29, 2015 in Featured, Infectious, Podcasts | 2 comments

Podcast Link: SGEM113 Date: March 26th, 2015 Guest Skeptics: Dr. Suneel Upadhye (BEEM Group) and Dr. Tiffany Osborn (ProMISe Author) Suneel is an Associate Clinical Professor Emergency Medicine at McMaster University and Associate Member of Clinical Epidemiology and Biostatistics. He is also the Chair CAEP standards committee and a sepsis researcher. Tiffany is the second author on the ProMISe Trial. She is an Associate Professor in the Department of Surgery and the Department of Emergency Medicine at Washington University, St. Louis. Case:  You see a 62 year-old man sent from a nursing home with a three day history of a productive cough, intermittent fevers and today is a bit confused. The transfer notes include a history of congestive heart failure, chronic obstructive pulmonary disease, gout, hypertension, type 2 diabetes, and mild dementia. His emergency department vitals are as follows: Temperature 39.1C, heart...

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SGEM#104: Let’s Talk about Sex Baby, Let’s Talk about STDs

Posted by on Jan 25, 2015 in Featured, Infectious, Podcasts | 3 comments

Podcast Link: SGEM104 STD Date: January 23rd, 2015 Guest Skeptic: Nadia Awad is an assistant professor of emergency medicine at the Ernest Mario School of Pharmacy at Rutgers University, and the emergency medicine pharmacist at Robert Wood Johnson University Hospital Somerset. She serves as associate editor and staff blogger of the blog, Emergency Medicine PharmD where she regularly contributes her thoughts, ideas, and clinical pearls related to her experiences in emergency medicine pharmacy and academia. Nadia also is the co-host of the EMPOWER Podcast. She is actively involved in research in areas that include emergency medicine, toxicology, disaster preparedness, acute neurocritical care, and social media in pharmacy education. She is a strong supporter of all that Free Open Access Medical Education (FOAMed) has to offer, and she hopes to continue to have a fulfilling experience in both learning from and contributing to...

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