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SGEM#174: Don’t Believe the Hype – Vitamin C Cocktail for Sepsis

Posted by on Apr 9, 2017 in Featured, Infectious, Podcasts | 11 comments

Podcast Link: SGEM174 Date: April 6th, 2017 Reference: Marik et al. Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest Dec 2016 Guest Skeptic: Dr. Jeremy Faust is an attending emergency physician at Brigham and Women’s Hospital in Boston Massachusetts and an instructor at Harvard Medical School. He’s the co-host of FOAMcast with co-host Dr. Lauren Westafer and he’s written about sepsis in the Annals of Emergency Medicine, EM Clinics of North America, and for mainstream audiences in Slate.  Case: A 60 year-old man is admitted to the ICU with severe sepsis from pneumonia. He has a history of hypertension and diabetes. You are providing him with intravenous fluids and appropriate antibiotics. When speaking with the family his son asks about a vitamin C cure he just read about? Background: We have covered...

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SGEM Xtra: Talk Trauma 2017- Tales from the Outer Rim

Posted by on Apr 7, 2017 in Conferences, Featured, Hematologic, Musculoskeletal, Podcasts, Trauma | 0 comments

Date: April 7th, 2017 Superstar Nurse Brenda Palsa and I had a wonderful time presenting at Talk Trauma 2017 this week in London, Ontario. It is a one day conference for nurses, allied health & EMS professionals involved in providing care for adult and paediatric trauma patients. Talk Trauma is put on by the London Health Science Centre (LHSC). We were honoured to return for a second year in a row to talk about managing trauma patients in the periphery.   Our idea was to demonstrate that you could provide excellent evidence based care before transferring patients to the trauma centre (LHSC). This resulted in Episode II – Tales from the Outer Rim (Talk Trauma Intro Trailer). I was inspired by ZdoggMD and dress up as Doc Vader while Brenda became Nurse Leia.   The entrance went well as we...

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SGEM#173: Diazepam Won’t Get Back Pain Down

Posted by on Apr 2, 2017 in Featured, Musculoskeletal, Podcasts | 1 comment

Podcast Link: SGEM173 Date: March 21st, 2017 Reference: Friedman BW et al. Diazepam is no better than placebo when added to naproxen for acute low back pain. Ann Emerg Med 2017. Guest Skeptic: Dr. Anand Swaninathan is an Assistant Professor of EM at NYU/Bellevue Hospital in the Department of Emergency Medicine. He is also part of REBEL EM, The Teaching Course and Core EM. Case: A 43-year-old woman who presents with an acute onset of back pain. She states she was carrying some heavy boxes when she slipped and although she didn’t fall, she felt her back wrench. There are no back pain “red flags” on your history and physical examination and after some treatment with a non-steroidal anti-inflammatory (NSAID) and a dose of morphine, the patient is improved. She still has pain and you notice that she’s got difficulty walking and bending...

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SGEM Xtra: Pura Vida IAEMC 2017

Posted by on Mar 31, 2017 in Conferences, Featured, Podcasts | 0 comments

Podcast Link: SGEM Xtra Pura Vida Date: March 23rd, 2017 Guest Skeptic: Dr. Manrique Umaña: Specialist in Emergency Medicine (ME), working as an assistant at San Juan de Dios Hospital and Hospital Cima, in San José, Costa Rica. He is the current National Coordinator and Professor of the Postgraduate Emergency Medicine (University of Costa Rica). He is also Professor of the Chair of Internal Medicine (UCIMED), member of the Costa Rican Association of Emergency Physicians (ASOCOME) and International member of ACEP and IFEM. Additionally, he is very active in the use of social networks (@umanamd) and writes in a Spanish ME blog called ViamedEM. This is an SGEM Xtra in support of the 7th Inter American Emergency Medicine Conference (IAEMC) being held in San Jose, Costa Rica May 22nd to 26th, 2017. My FOAMed friend Manrique reached out to me and asked if...

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SGEM#172: Don’t Bring My Blood Pressure Down (Intensively) – The ATACH2 Trial

Posted by on Mar 26, 2017 in Featured, Hematologic, Neurologic, Podcasts | 3 comments

Podcast Link: SGEM172 Date: March 21st, 2017 Reference: Qureshi et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. NEJM June 2016 Guest Skeptic: Chip Lange is an Emergency Medicine Physician Assistant working primarily in rural Missouri in community hospitals. He has international experience in critical care and emergency medicine. He hosts a blog and podcast called TOTAL EM, which stands for Tools Of the Trade and Academic Learning in Emergency Medicine. Although Chip’s focus is to educate those working in rural and remote settings, his goal has been to help others provide total care everywhere. Case: A 68 year-old female arrives via EMS for left sided weakness starting two hours prior to arrival in the emergency department. She does not take blood thinners and has lived independently prior to her complaint today. Her head CT without contrast demonstrates a...

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SGEM#171: Step-by-Step Approach to the Febrile Infant

Posted by on Mar 12, 2017 in Featured, Infectious, Pediatrics, Podcasts | 6 comments

Podcast Link: SGEM171 Date: February 27th, 2017 Reference: Gomez et al. Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Pediatrics 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 also the creator of SketchyEBM. Case: A 25-day-old girl presents with fever. There is no history of congestion, cough, vomiting, diarrhea, shortness of breath or any other focus for her infection. She looks well on exam and her vitals are normal except for a rectal temperature of 38.3C. She is less than 28 days old and you wonder how much of a work up to do (full septic workup, intravenous antibioticsadmission to hospital, blood and urine tests)? Background: Fever without source in infants less than three months old...

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