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SGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It.

Posted by on Jun 11, 2017 in Featured, Hematologic, Neurologic, Podcasts | 3 comments

Podcast Link: SGEM182 Date: June 5th, 2017 Reference: Baharoglu et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016. Guest Skeptic: Dr. Robert Edmonds is an Emergency Medicine staff physician in Newport News, VA and a recent graduate of the University of Missouri-Kansas City EM residency. DISCLAIMER – The views and opinions of this podcast/blog do not reflect the views and opinions of the US Air Force, the United States Government, or Langley Air Force Base. Case: Your next patient is a 68-year-old with sudden onset right sided hemiparesis and facial droop.  Non-contrast head CT shows a hemorrhagic stroke.  On review of the patient’s medications you notice the patient is taking daily aspirin. You wonder if they would benefit from a platelet transfusion. Background: In...

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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

Posted by on Jun 4, 2017 in Featured, Podcasts, Trauma | 6 comments

Podcast Link: SGEM181 Date: June 3rd, 2017 Reference: Sierink et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet August 2016. Guest Skeptic: Dr. Marcel Emond is an Associate Professor, Laval University, Emergency Physician at the Level 1 Trauma Center of the CHU de Québec, a Senior Clinician-Scientist, Chair of CAEP Trauma and Injury prevention committee, BEEM faculty member and the host of SGEM Global French. Case: A 53-year-old woman in good health is brought in by ambulance after a motor vehicle collision. She did not lose consciousness but did bump her head.  Her main complaint is chest pain with difficulty breathing. She is tachycardic, tachypnic and has some mild abdominal pain. You suspect a flail chest on your clinical examination.  A FAST examination is performed and is...

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SGEM#180: The First Cut is the Deepest – N.O.T. for Paediatric Appendicitis

Posted by on May 28, 2017 in Featured, Pediatrics, Podcasts | 3 comments

Podcast Link: SGEM180 Date: May 24th, 2017 Reference: Georgiou et al. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Pediatrics 2017. Guest Skeptic: Dr. Ross Fisher is a Paediatric Surgeon in Sheffield, England. When he is not waxing lyrical about presentation skills (P Cubed) over at ffolliet.com, giving the Greatest Presentation in the World at SMACC or expounding his views on paediatric trauma management he can be found at Sheffield Children’s Hospital principally dealing with surgical oncology, vascular access and all sorts of neonatal surgical problems. Case: It is 7pm on a quiet evening in the emergency department and Bobby comes in. He’s 12 years old and complains of a belly ache, pointing to his right iliac fossa pain. It has been going on for about 36 hours now, initially peri-umbilical and associated with nausea, poor appetite and malaise.  It has increased...

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SGEM#179: Chase the Dragon and Naloxone

Posted by on May 21, 2017 in Featured, Pharmacology/Toxicology, Podcasts, Pulmonary | 3 comments

Podcast Link: SGEM179 Date: May 19th, 2017 Reference: Willman et al. Do heroin overdose patients require observation after receiving naloxone? Clinical Toxicology 2017. Guest Skeptic: Dr. Richard Hamilton (@RJHamiltonMD) is Chair of the Department of Emergency Medicine at Drexel University College of Medicine. He is also the host of EMToxCast and gave a talk at the Association of Academic Chairs of Emergency Medicine Annual Retreat called: Can Social Media Save Emergency Medicine? Case: A 45-year-old male arrives via emergency medical services (EMS) complaining that he wants to be discharged. EMS states they found him unresponsive and with paraphernalia consistent with intravenous heroin use. His prehospital vital signs were oxygen saturation of 89% and respiratory rate of six breaths per minute prior to administration of oxygen and 1 mg of naloxone. After naloxone administration he is alert and oriented times three with a normal pulse oximetry and clear lung fields....

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SGEM#178: Mindfulness – It’s not Better to Burnout than it is to Rust

Posted by on May 14, 2017 in Featured, Podcasts, Psychiatric | 5 comments

Podcast Link: SGEM178 Date: May 12th, 2017 Reference: Ireland et al. A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher 2017. Guest Skeptic: Dr. Diane Birnbaumer is a Senior Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. She is also an Emeritus Professor of Medicine at the David Geffen School of Medicine at UCLA. Case: A resident comes to you looking for advice. He is having trouble feeling tired, short-tempered and it is affecting his work interactions and personal sense of satisfaction with his job. You suspect he is suffering from early burnout. Background: Burnout is certainly a hot topic, and mindfulness has hit the front pages of the New York Times and Time Magazine, putting it front and center in the public eye. Burnout was a term coined by Herbert Freudenberger in 1974 (1). There are...

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SGEM#177: POCUS – A New Sensation for Diagnosing Pediatric Fractures

Posted by on May 7, 2017 in Featured, Musculoskeletal, Pediatrics, Podcasts | 40 comments

Podcast Link: SGEM177 Date: May 1st, 2017 Reference: Poonai et al. Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 2017. Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the AAEM MedEdPORTAL SGEM HOP: This is another SGEM Hot Off the Press with Academic Emergency Medicine. Here is a reminder of how this special edition of the SGEM works: A paper that has been submitted, peer-reviewd, and accepted for publication in AEM is selected. The SGEM puts its skeptical eye upon the manuscript using the modified BEEM critical appraisal tool. One of the authors is invited to discuss their work on the SGEM podcast. A special SGEM Hot Off the Press blog is posted...

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