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SGEM#158: Tempted by the Fruit of Another – Dilute Apple Juice for Pediatric Dehydration

Posted by on Jun 19, 2016 in Featured, GastroIntestinal, Infectious, Pediatrics, Podcasts | 2 comments

Podcast Link: SGEM158 Date: June 15th, 2016 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. He is the creator of SketchyEBM. Case: A 2-year-old girl presents with a two-day history of vomiting and diarrhea. She is minimally dehydrated and tolerating oral fluid only. You remember reading about the sodium-glucose co-transporter and electrolyte fluids that were initially developed by the World Health Organization for children with diarrheal diseases. You have heard parents ask about just using watered down juice and debate whether this is a viable option for these children. Background: Gastroenteritis is a common illness in children and these children are at risk of dehydration from inadequate intake, excessive losses or both together. If children are unable to tolerate oral...

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SGEM#157: Nebulized Hypertonic Saline for Acute Bronchiolitis

Posted by on Jun 12, 2016 in Featured, Pediatrics, Podcasts | 1 comment

 Podcast Link: SGEM157 Date: June 6th, 2016 Guest Skeptic: Dr. Chantal Guimont. Chantal is a Family Doctor who works in a in a mixed pediatric and adults tertiary care center in Quebec City. She has a PhD in epidemiology and is on faculty at Laval University. Case: You are working in the emergency department when an eight months old presents with nasal congestion, tachypnea, and retractions. You suspect he suffers from a acute bronchiolitis. You wonder about the most accurate and up to date treatment options. Background: During winter months in Quebec, and I suspect it is the same in many other places, bronchiolitis is one of the most frequent emergency department complaints. Bronchiolitis is the most common disease of the lower respiratory tract infection seen in children less than one year of age. They tend to present similar to...

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SGEM#155: Girls Just Want To Have Fun – Not Appendicitis

Posted by on May 29, 2016 in Featured, Infectious, Pediatrics, Podcasts | 13 comments

Podcast Link: SGEM155 Date: May 24th, 2016 Guest Skeptics:  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. He is the creator of SketchyEBM. Case: A 15-year-old female patient presents to your emergency department with a chief compliant of abdominal pain. A medical student picks up the chart and comes back to tell you about the case. His presentation includes that the abdominal pain has been going on for two days, has worsened over this time period, and is worse in the right lower quadrant from previously being around her umbilicus. She had a temperature this morning of 101 degrees Fahrenheit, vomited twice this morning (non-billious, non-bloody), says the bumps in the road travelling to your hospital hurt badly, and she doesn’t want to...

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SGEM#132: One Balloon for Otitis Media with Effusion

Posted by on Oct 19, 2015 in Featured, Pediatrics, Podcasts | 3 comments

Podcast Link: SGEM132 Date: October 15th, 2015 Guest Skeptic: Dr. Richard Lubell is a community pediatrician in London, Ontario with over 30 years of experience. He is an associate professor in the Department of Pediatrics at Western University. Case: A four-year-old boy presents to the emergency department after being picked up from school. The mother is worried he has another ear infection. This is because the teacher thought he was having trouble hearing in class. The child completed a course of antibiotics two months ago for acute otitis media. On examination the child looks well and has no fever. Otoscopic examination demonstrates some fluid behind the tympanic membrane. Background: Otitis media with effusion or glue ear can be defined as a condition that that persists for more than six weeks. There were over two million cases diagnosed in the USA in...

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SGEM#127: Suspicious Minds vs. Clinical Prediction Rule in Children with Trauma

Posted by on Sep 13, 2015 in Featured, Pediatrics, Podcasts, Trauma | 13 comments

Podcast Link: SGEM127 Date: September 8th, 2015 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. I often refer to him as a PedsEM Super Hero but the SGEMers probably know him for his RANThony’s on YouTube. Season#3 finished with an SGEM#126 Hot Off the Press featuring Dr. Jeff Kline discussing outpatient management of venous thromboembolism. We are going to kick off Season#4 with another SGEM HOP from Academic Emergency Medicine. SGEM Hot Off the Press Process: We select a paper that has been accepted by the editors at Academic Emergency Medicine that is about to be published. The SGEM then put a skeptical eye upon the manuscript using a modified BEEM critical appraisal tool. One of the authors is then invited...

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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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