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SGEM#228: Winds of Change – High Flow Nasal Oxygen for Acute Bronchiolitis?

Posted by on Sep 8, 2018 in Featured, Infectious, Pediatrics, Podcasts | 0 comments

Podcast Link: SGEM228 Date: September 5th, 2018 Reference:  Franklin et al. A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis. NEJM March 2018. Guest Skeptic: Dr. Ben Lawton is a paediatric emergency physician in Brisbane Australia. He divides his time between a tertiary children’s hospital and a community hospital that is busy enough to have its own paediatric emergency department. He is part of the Don’t Forget the Bubbles team. Case: Elsie is five months old and presents on day two of a bronchiolitic illness. She has taken just under half of her usual feeds so far today and has a respiratory rate of 58 breaths per minute and oxygen saturation of 90% on room air with moderate work of breathing. She is not clinically dehydrated and has a temp of 38.2C with clear rhinorrhea, red ears, a red throat and...

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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#213: Upside Down You Convert Me Out of SVT?

Posted by on Apr 1, 2018 in Cardiac, Featured, Pediatrics, Podcasts | 5 comments

Podcast Link: SGEM213 SVT Date: March 30th, 2018 Reference: Bronzetti et al. Upside-down position for the out of hospital management of children with supraventricular tachycardia.  International Journal of Cardiology. February 2018. Guest Skeptic: Dr. Robert Edmonds is an Emergency physician in the US Air Force. This is his 6th 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:A seven-year-old girl presents to your emergency department complaining of palpitations.  On exam she appears anxious and begs you not to give “that drug that makes my heart stop like that last doctor did.”  You know vagal maneuvers are first-line, but there’s variation in techniques.  As the patient already tried breathing out of her clenched nose, you wonder if there is another safe method you can try prior to medications. Background: Supraventricular...

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SGEM#206: I’m Wheezy Like A Pre-Schooler – Prednisolone for Wheezy Children

Posted by on Feb 10, 2018 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 10 comments

Podcast Link: SGEM206a Date: February 6th, 2018 Reference: Foster SJ et al. Oral prednisolone in preschool children with virus-associated wheeze: a prospective, randomised, double-blind, placebo-controlled trial. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. She is also the co-founder of Don’t Forget the Bubbles and on the FeminEM Speaker Bureau. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. He has been taking salbutamol at home today but he’s still not improving. He has mild work of breathing and a bilateral wheeze. His oxygen saturation is 94% on room air. Tom has no other previous medical history. You start to write up the salbutamol, but should you give him a dose of prednisolone too? Background: We see “little wheezers”...

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SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations

Posted by on Nov 12, 2017 in Featured, Pediatrics, Podcasts | 9 comments

Podcast Link: SGEM194 Date: November 9th, 2017 Reference: Cronin JJ et al. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department. Ann Emerg Med 2016 Guest Skeptic: Dr. Michael Falk is a Pediatric Emergency Medicine provider who works at Harlem Hospital Center in New York and Children’s National Medical Center in Washington, DC.  He was Director of Emergency Department Simulation and the Co-Fellowship Director at ST Luke’s-Roosevelt Hospital in New York and is a Best Evidence in Emergency Medicine (BEEM) presenter and author. This episode is based upon a BEEM critical review. Case: A four-year old male who is a known asthmatic presents to the emergency department with an asthma exacerbation. He has been sick with an upper respiratory infection for the last two days. He is getting worse despite his...

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SGEM#193: Stop, In the Name of Love

Posted by on Oct 29, 2017 in Featured, Pediatrics, Podcasts | 4 comments

Podcast Link: SGEM193 Date: October 24th, 2017 Reference: Harrison et al. Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis. Pediatrics 2017 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. Anthony is also the creator of SketchyEBM. Case: A 12-day old girl presents with fever and is otherwise well. You are planning to begin a full septic workup including some painful procedures including bloodwork.  You wonder whether there is a way to mitigate the painful experience for the child. Background: Painful procedures are common in the neonatal period, including bloodwork, lumbar punctures and bladder catheterization. There is evolving evidence to the long-term neuro-developmental harms associated with pain in the preterm infants (Field T. Infant Behavior and Development 2017) We have covered pain...

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