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SGEM#236: TXA – Not for Brain Bleeds

Posted by on Nov 7, 2018 in Hematologic, Neurologic, Podcasts | 0 comments

Podcast Link: SGEM236 Date: November 6th , 2018 Reference: Sprigg et al. Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial. Lancet. 2018 Guest Skeptic: Dr. Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s eighth visit to the SGEM. DISCLAIMER: The views and opinions of this podcast do not represent the United States Government or the US Air Force. Case: Your next patient is a stroke alert for a 67-year-old male living at a nursing home presents with severe right sided upper and lower extremity weakness noticed one hour ago while eating a meal.  He obtains a stat head CT which shows an intracerebral hemorrhage.  In addition to controlling his elevated blood pressure, you wonder if there is more you can offer this patient to improve his outcome and odds...

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SGEM#232: I Can See Clearly Now the Collar is Gone – Thanks to the Triage Nurse

Posted by on Oct 6, 2018 in Musculoskeletal, Neurologic, Podcasts, Trauma | 0 comments

Podcast Link: SGEM232 Date: October 5th , 2018 Reference: Stiell et al. A Multicenter Program to Implement the Canadian C-Spine Rule by Emergency Department Triage Nurses. Annals of EM Oct 2018 Guest Skeptic: Alison Armstrong is an Emergency Department Nurse, TNCC Course Director, Trauma Program Coordinator and Canadian C-Spine Rule Nurse Champion. Case: There are two case scenarios this week to try and capture the two common ways patients present to the triage nurse. Case 1: A 51-year-old male patient presents to triage in a collar on a back-board via EMS following a rear-end motor vehicle collision (MVC) at a stop light. He was a belted driver with no past medical history and GCS 15. The driver of the car that hit him was texting and did not appear to slow before striking the rear of the patient’s car at about 50 km/hr....

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SGEM#225: NEXUS II – Validation of the Pediatric Head CT Decision Instrument

Posted by on Jul 17, 2018 in Featured, Neurologic, Pediatrics, Podcasts, Trauma | 0 comments

Podcast Link: SGEM225 Date: July 16th, 2018 Reference: Gupta M et al. Validation of the Pediatric NEXUS II Head Computed Tomography Decision Instrument for Selective Imaging of Pediatric Patients with Blunt Head Trauma. AEM July 2018 Guest Skeptics: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine Case: You’re working in a small rural emergency department when a seven-year-old girl comes in by EMS with a head injury. Her father was teaching her how to bike and he got a little ambitious and sent her down a small hill. She hit a rock, and went over the bars, striking her head on a small tree as she fell. She was helmeted, she did not lose consciousness, has not been vomiting, but the helmet was scratched up where it struck the tree. It’s...

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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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