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SGEM#150: Hypertonic Saline for Traumatic Brain Injury

Posted by on Mar 27, 2016 in Featured, Neurologic, Podcasts, Trauma | 20 comments

Podcast Link: SGEM150 Date: March 24th, 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). Lead Author: Dr. Elyse Pelletier. Elyse works at the Centre de Recherche CHU de Québec, Population Health and optimal Health Practices Unit. She is also in the Department of Family and Emergency Medicine, Université Laval, Québec, QC, Canada. Case: A 21-year-old male is standing on the corner, minding his own business (SOCMOB) when he is hit in the head with a bat and suffers a severe traumatic brain injury. He is brought into the trauma room and appears to have...

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SGEM#140: CT Scans to Rule Out Subarachnoid Hemorrhages In A Non-Academic Setting

Posted by on Dec 13, 2015 in Featured, Neurologic, Podcasts | 3 comments

Podcast Link: SGEM140JC Date: December 9th, 2015 Guest Skeptics: Dr. Fareen Zaver is a Chief Resident in Emergency Medicine at the George Washington University, specifically in charge of the medical education resident curriculum and Grand Rounds schedule. She is the co-founder and lead editor of the ALiEM AIR-Pro series and is pursuing an academic career in Medical Education. She was born and raised in Calgary, Alberta and has constantly stood out with her Canadian accent and roots. She will always be a diehard Calgary Flames fan and is joining the University of Calgary Emergency Medicine department in August when she completes her residency. Dr. Stefanie Gilbert is a Chief Resident in Emergency Medicine at The George Washington University in the heart of the nation’s capital. Her career interests include ED administration with a focus on operations and quality improvement. Prior to residency, she completed a...

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SGEM#137: A Foggy Day – Endovascular Treatment for Acute Ischemic Stroke

Posted by on Nov 22, 2015 in Featured, Neurologic, Podcasts | 2 comments

Podcast Link: SGEM137 Date: November 21st, 2015 Guest Skeptic: Dr. Rory Spiegel is an Emergency Medicine resident in New York City. Rory is doing a resuscitation fellowship at Stony Brook University School of Medicine. He also writes a blog called EM Nerd about nihilism, medicine and the art of doing nothing. Case: An 78-year-old woman presents to your emergency department with right arm weakness and slurred speech for the last two hours.  She has a history of hypertension and diabetes. A CTA is performed that shows an Intracranial arterial occlusion of the right M1 middle cerebral artery segment. Background: Prior to the publication of MR CLEAN and the four trials published in its wake, the data regarding endovascular therapy has been consistently negative. Over the past year five RCTs examining endovascular therapy for acute ischemic stroke have been published. In direct contrast to...

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SGEM#134: Listen, to what the British Doctors Say about LPs post CT for SAH

Posted by on Nov 1, 2015 in Featured, Neurologic, Podcasts | 20 comments

Podcast Link: SGEM134 Date: October 27th, 2015 Guest Skeptic: Dr. David Sayer is a physician completing his general practice training in the United Kingdom. Case Scenario: A 34-year-old woman presents with acute onset of headache peaking in 30 minutes with no recent trauma, focal deficits and a normal neurologic examination. Background: Headaches represent around 2% of all emergency department visits. Of these presentations 1-3% turn out to be a subarachnoid hemorrhage (SAH)  (Edlow, Vermeulen, Perry, Morgenstern). About 5% of SAH are misdiagnosed on the first emergency department assessment (Vermeulen). This is partly because 50% of SAH present with no neurologic deficit (Weir). Dr. Jeff Perry and his team have tried to create a clinical decision tool to rule out SAH for acute headaches (SGEM#48). The Ottawa SAH Tool contains six variables to decide if a CT scan is necessary. Applying the tool could decrease the...

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SGEM#124: Ultrasound for Skull Fractures – Little Bones

Posted by on Jun 14, 2015 in Featured, Musculoskeletal, Neurologic, Pediatrics, Podcasts, Trauma | 2 comments

Podcast Link: SGEM124 Little Bones Date: June 11th, 2015 Guest Skeptic: Dr. Greg Hall. Greg is Director of EM Ultrasound at the Brantford General Hospital in Brantford Ontario and Assistant Clinical Professor at McMaster University.  He is Vice President of the Canadian Emergency Ultrasound Society, co-author of Point-of-care Ultrasound for Emergency Physicians, co-creator of the EDE 2 Course: Advanced Emergency Department Echo, and director of the EDE 3 Course, a leading edge POCUS workshop. Case: An 18 month old male presents to your small emergency department having a witnessed fall off a couch and hit his head on a hardwood floor.  He threw up once and cried immediately at the scene.  There was no loss of consciousness. The parents are concerned about a serious head injury, particularly with the large hematoma, but understandably are not thrilled with the idea of the...

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SGEM#112: Bang Your Head – Paediatric Concussions

Posted by on Mar 22, 2015 in Featured, Neurologic, Pediatrics, Podcasts | 0 comments

Podcast Link: SGEM112 Concussion Date: March 7th, 2014 Guest Skeptic: Dr. Anthony Crocco. Associate Professor, McMaster University, Medical Director and Division Head McMaster Children’s Hospital Emergency Department. Case: 11yo snowboarder fails to land epic jump. She was wearing helmet. There was a brief loss of consciousness and she is amnestic to the event. The only complaint is a mild headache. Her examination is normal and a shared decision is made to observe her rather than getting a CT scan. She is ultimately diagnosed with a concussion. When leaving the department she wants to know when can she go back shreddin’ the gnar? Background: Pediatric traumatic brain injury (TBI) is a leading cause of death and disability. The Center for Disease Control (CDC) has called it a national health problem. TBIs are responsible for close to 500,000 ED visits, over 35,000 hospitalizations...

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