SGEM#222: Rhythm is Gonna Get You – Into an Atrial Fibrillation Pathway
Podcast Link: SGEM222 Date: June 12th, 2018 Reference: DeMeester S et al. Implementation of a Novel Algorithm to Decrease Unnecessary Hospitalizations in Patients Presenting to a Community Emergency Department With Atrial Fibrillation. AEM June 2018 Guest Skeptic: Dr. Morgenstern is an emergency physician and the Director of Simulation Education at Markham Stouffville Hospital in Ontario. He is the creator of the excellent #FOAMed project called First10EM.com and an amazing photographer. Case: A 62-year-old Canadian is on vacation in up-state Michigan, and after a celebratory evening, presents to your emergency department with palpitations. “I’ve had atrial fibrillation a number of time before. Usually they just shock me and send me home.” Local practice is usually to treat rapid atrial fibrillation with a calcium channel blocker infusion and admit to hospital. As the conversation progresses, you wonder whether it might be safe to discharge some atrial fibrillation...
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SGEM#221: Smells Like Isopropyl Alcohol for Nausea
Podcast Link: SGEM221 Date: June 8th, 2018 Reference: April MD, et al. Aromatherapy Versus Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients: A Randomized Controlled Trial. Ann Emerg Med 2018 Guest Skeptic: Meghan Groth is a pharmacist who has been practicing in emergency medicine for the past six years. She’s recently transitioned into industry, taking on a position as a medical science liaison in New England. She’s been a contributor for the Academic Life in Emergency Medicine and Emergency Medicine PharmD blogs and is a member of the ALiEMU Capsules team. Case: A 32-year-old woman presents to your emergency department with complaints of nausea (nausea VAS is about a 5 on a scale of 0 to 10) and states she’s worried she’s coming down with some sort of stomach flu. She’s hemodynamically stable and looks a bit queasy but isn’t actively...
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SGEM Xtra: Don’t Give Up – The Power of Kindness with Brian Goldman
Podcast Link: SGEM Xtra Kindness with Brian Goldman Date: May 26th, 2018 This is a SGEM Xtra book review. I had the honour of meeting and interviewing Dr. Brian Goldman at the Canadian Association of Emergency Physician (CAEP) annual scientific assembly in Calgary. Dr. Goldman is an Emergency Medicine physician who works at Mount Sinai hospital in Toronto. He is the host of CBC radio show White Coat Black Art and the author of the bestselling books The Night Shift and the Secret language of Doctors. Dr. Goldman has a fantastic new book called The Power of Kindness: Why Empathy is essential in Everyday life. Listen to the podcast on iTunes to hear Brian answers questions about kindness: Define kindness, what is difference between kindness and empathy and what is synchrony? What is one of your favourite stories from the book about kindness?...
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SGEM#220: Acupuncture vs. Morphine for Renal Colic
Podcast Link: SGEM220 Date: May 16th, 2018 Reference: Beltaief K et al. Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial. J Pain Res. 2018 Guest Skeptic: Dr. Tony Seupaul is the Chairman of the Department of Emergency Medicine, University of Arkansas. Dr. Cordell Cunningham is a PGY 2 in Emergency Medicine at University of Arkansas for Medical Sciences Case: A 51-year-old man presents to the emergency department complaining of right flank pain radiating to his groin like his previous episodes of renal colic. He states the pain comes in “waves,” is associated with nausea but no vomiting. On exam, he is afebrile and appears very uncomfortable while grabbing his right flank. He has used ketorolac, acetaminophen and tamsulosin in the past. He really wants to avoid taking any opioids and is wondering if acupuncture could work? Background: We have covered renal colic...
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SGEM#219: Shout, Shout, PERC Rule Them Out
Podcast Link: SGEM219 Date: May 16, 2018 Reference: Freund et al. Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients: The PROPER Randomized Clinical Trial. JAMA February 2018. Guest Skeptic: Dr. Jeffrey Kline (@klinelab) is the Vice Chair of Research in Emergency Medicine and a professor of physiology, Indiana University School of Medicine. He is the editor in chief of AEM, creator of Pulmonary Embolism Rule-out Criteria (PERC) Rule and has published extensively in the area of pulmonary emboli. We have even made a Batdoc Video together on pulmonary embolism. Case: A 47-year-old woman presents to the emergency department with a 24-hour history of chest pain and shortness of breath. She has a past medical history of hypothyroidism and gastroesophageal reflux disease. She is on levo-thyroxine and a proton pump inhibitor. Vital signs are normal (HR...
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SGEM#218: Excited Delirium Syndrome
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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