SGEM#217: The Batman Effect on Improving Perseverance
Podcast Link: SGEM217 Date: March 6th, 2018 Reference: White et al. The “Batman Effect”: Improving Perseverance in Young Children. Child Development December 2016. Guest Skeptic: Dr. Casey Parker is a rural Generalist working in Broome, Australia. He has particular interests in Emergency Care, Aboriginal Health, Paediatrics, Trauma and Women’s Anaesthesia. Casey has this great blog and podcast called Broome Docs. Casey and I made a #Batdoc video at SMACCdub. Case: It is flu season and there is an endless stream of patients with sniffles, snot and sneezes! The waiting room is moaning with mildly unwell men; all with ‘the worst cold ever!” The residents are working double shifts in order to cover their fallen comrades. They are doing their best to avoid prescribing antibiotics whilst avoiding being coughed upon and writing endless, uninspiring discharge letters to the primary care docs. It is a...
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SGEM Xtra: Petition to Retire the Surviving Sepsis Campaign Guidelines
Recently the SGEM was contacted by a group of doctors organizing a petition. They were concerned about the new Surviving Sepsis Campaign (SCC) guidelines that were just released. Specifically, the fluid, antibiotics and pressor requirements within the first hour of being triaged in the emergency department. The SGEM was invited to be involved in a global effort to express the concerns about the SSC guidelines. Below is the letter being released from a number of #FOAMed people from around the world today with a link to an online petition. Please review the information and consider signing the petition. The next SGEM episode will be a standard critical appraisal of a recent publication. The goal remains to try and cut the knowledge translation window down from over ten years to less than one year using social media. We ultimately want...
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SGEM#216: Pump It Up – Corticosteroids for Patients with Pneumonia Admitted to Hospital
Podcast Link: SGEM216 Date: April 25th, 2018 Reference: Stern A et al, Corticosteroids for pneumonia (Review). Cochrane Database of Systematic Reviews. December 2017. Guest Skeptic: Dr. Jake Turner, a foundation doctor working in the UK. Case: A 72-year-old gentleman presents to your emergency department. He has been generally unwell for around one week, with a worsening cough, shortness of breath and fever. He is now feeling extremely short of breath, appears confused and is pyrexial at 39 degrees centigrade. His observations are heart rate of 102 beats per minute, respiratory rate of 34 breaths per minute, blood pressure of 110/67 mmHg, and oxygen saturation of 91% on room air. Background: There have been a large number of trials on steroids for a variety of conditions in the last year and we have covered some of them on the SGEM: The ADRENAL trial on...
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SGEM#215: Love Will Tear Us Apart – Diagnostic Challenges of Aortic Dissection
Podcast Link: SGEM215a Date: April 12th, 2018 Reference: Ohle R et al. Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis. AEM April 2018 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine (AEM). Case: You are in the emergency department caring for a 65-year-old man with sharp chest pain radiating to the back. Blood pressure is elevated, and his pain was sudden in onset. His chest x-ray is normal, and there is no sign of asymmetric pulses. The EKG and laboratory tests are normal. You are wondering if you need to order a CT to rule out an aortic dissection. Background: Aortic dissection is a rare but deadly disease which can confound the emergency physician’s diagnostic abilities. Some estimates are that up to 38% of cases are initially...
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SGEM#214: Woman – The TXA Trial for Post-Partum Hemorrhage
Podcast Link: SGEM214 Date: April 13th, 2018 Reference: Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. The Lancet 2017 Guest Skeptic: Dr. Nick Papalia completed his MD at Western University. He is currently completing his third year of Obstetrics and Gynecology residency at the University of Calgary. Case: 37-year-old primiparous woman has a spontaneous vaginal delivery following an induction of labour at 39 weeks for gestational diabetes for which she is treated with insulin. She delivered a vigorous 3800g boy following a brief episode of shoulder dystocia. She is otherwise healthy but does have a remote history of asthma. Aside from insulin and prenatal vitamins, she takes no medications. Approximately five minutes after delivery of the placenta, as you are evaluating her perineum, she begins to have...
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SGEM Xtra: The Danger Within Us
Podcast Link: SGEM Xtra Danger Within Us Date: March 23rd, 2018 This is a SGEM Xtra book review. I had the pleasure of interviewing Jeanne Lenzer. She is an award-winning independent medical investigative journalist who has written for the BMJ. Jeanne has also written for the Atlantic, the New York Times Magazine, Mother Jones, Huffington Post and Slate. Jeanne book is called The Danger Within Us: America’s Untested, Unregulated Medical Device Industry and One Man’s Battle to Survive It. In the book, she takes a critical look at the medical device industry. One of the main inspiration for her book is the Legend of Emergency Medicine Dr. Jerome Hoffman. He is also one of my mentors who taught me to be skeptical of the medical literature. Listen to the podcast on iTunes as Jeanne describes some of the problems with the medical device industry. Some of the disturbing facts she provides include: Medical...
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