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SGEM#218: Excited Delirium Syndrome

Posted by on May 12, 2018 in Featured, Neurologic, Pharmacology/Toxicology, Podcasts, Psychiatric | 0 comments

Podcast Link: SGEM218 Date: May 12th, 2018 Reference: Gonin P et al. Excited Delirium: A Systematic Review. AEM May 2018. Guest Skeptic: Dr. Chris Bond 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: A 24-year-old male is brought into the emergency department by police. He was running around wearing a Batman suit, jumping on cars and screaming he is Batman. He is brought to the emergency department extremely agitated and despite being held down by two police and three security guards he is still trying to bite the staff. You cannot obtain any vital signs and this patient is a danger to himself and...

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SGEM#211: Pins and Needles – Acupuncture for Migraine Prophylaxis

Posted by on Mar 18, 2018 in Featured, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM211 Date: March 18th, 2018 Reference: Zhao et al. The Long-Term Effect of Acupuncture for Migraine Prophylaxis:  A Randomized Clinical Trial. JAMA Internal Medicine 2017 Guest Skeptic: Dr. Alfred Sacchetti is a full time practicing Emergency Physician, who is also the Chief of Emergency Medicine at Our Lady of Lourdes Medical Center in Camden, New Jersey, USA, an Assistant Clinical Professor of Emergency Medicine, an Active Researcher and faculty member for the Emergency Medicine and Acute Care course.   Case: 40-year-old male appears with what he describes as his typical migraine that has failed his usual home therapies.  In the emergency department after six hours and multiple medications, the patient’s pain is finally under control.  While being discharged he asks if there anything you can offer to prevent headaches from coming back. He states: “I have to fly to Chengdu University of Traditional...

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SGEM#201: It’s in the Way That You Use It – Ottawa SAH Tool

Posted by on Jan 7, 2018 in Featured, Neurologic, Podcasts | 8 comments

Podcast Link: SGEM201 SAH Date: December 19th, 2017 Reference: Perry J et al. Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ Nov 2017 Guest Skeptic: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medicine and Critical Care course. Case:  A 35-year-old female presents to your emergency department three-hours after the onset of a severe frontal headache.  She describes the headache as throbbing, left retro-orbital, and associated with nausea but no vomiting.  As a teenager, she had a history of frequent migraine headaches, but she cannot recall any migraine for at least ten years. The headache developed over an hour while at her desk job and was not associated with loss of consciousness, neck pain, fevers, or neurological deficits. Your physical exam is normal. Last week, your colleague missed...

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SGEM#199: Therapeutic Hypothermia – What is it Good For?

Posted by on Dec 17, 2017 in Featured, Neurologic, Podcasts | 4 comments

Podcast Link: SGEM199 Date: November 27th, 2017 Reference: Legriel et al. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Case: Johnny is a 22-year-old male patient who presents to the emergency department via EMS with a seizure. He is known to have poorly controlled epilepsy. It was a witnessed clonic-tonic seizure that stopped but he did not wake up. The paramedics report another seizure on route to the hospital. He arrives with normal vital signs, normal finger stick blood glucose and a Glasgow Coma Scale of 3. He then has another seizure in the department. You quickly assess him in the resuscitation room, the team attempts...

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SGEM#187: Pin Cushion – Acupuncture in the Emergency Department

Posted by on Sep 10, 2017 in Featured, Musculoskeletal, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM187a Date: September 7th, 2017 Reference: Cohen et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. MJA 2017 Guest Skeptic: Dr. Alfred Sacchetti is a full time practicing Emergency Physician, who is also the Chief of Emergency Medicine at Our Lady of Lourdes Medical Center in Camden, New Jersey, USA, an Assistant Clinical Professor of Emergency Medicine and an Active Researcher.   In addition, Dr. Sacchetti is one of the few individuals to have lectured on the same panel with Dr. Milne and survived with his sanity and reputation intact. Case: A 41-year-old man presents to the emergency department with an acute onset of back pain. He was putting some groceries into the car and felt something pull in his lower back.  He has no “red flags” on your history and physical examination. He is worried about...

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SGEM#183: Don’t RINSE, Don’t Repeat

Posted by on Jun 25, 2017 in Cardiac, Featured, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM183 Date: June 20th, 2017 Reference: Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016. Guest Skeptic: Jay Loosley is a Registered Nurse, and an Advanced Care Paramedic in London.  His background includes working as a Research Assistant with the Ottawa Hospital Research Institute, Professor at Fanshawe College and currently, Superintendent of Education for Middlesex-London EMS, in London, Ontario, Canada. Case:  A 71-year-old woman has a witnessed arrest while watching her granddaughter’s soccer game. By-standard CPR is started and EMS is called. They arrive quickly and take over the resuscitation. She is not in a shockable rhythm. They continue CPR, get intravenous access, give a round of epinephrine and then wonder if they should start rapid cooling en-route to the hospital...

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