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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 | 8 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 Special: O Captain! My Captain

Posted by on Aug 19, 2014 in Featured, Podcasts, Psychiatric | 2 comments

Podcast Link: SGEM O Captain Date:  August 18th, 2014  As many of you know actor and comedian Robin Williams died last week. I am having difficulties processing the loss. There are feelings of anger, sadness and disbelief. It is weird; a person I have only known through movies has had a profound effect on me. Robin Williams made a huge impact on my desire to teach, the way I teach and the goal to inspire independent critical/skeptical thinking students. It must be affecting others in the EM community too. A SGEM listener emailed asking if there would be an episode dedicated to Robin Williams. I was not sure if it would be respectful or appropriate. As always, when I am not sure of things I check with people I hold in high regard. So I contacted Rob Rogers (I Teach...

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SGEM#59: Can I Get A Witness (Family Members Present During CPR)

Posted by on Jan 12, 2014 in Cardiac, Featured, Podcasts, Psychiatric | 3 comments

Podcast Link: SGEM59 Date:  January 12, 2014 Guest Skeptic: Darin Abbey is a clinical nurse educator for the emergency department in Nanaimo, British Columbia. Case Scenario: You are working in a busy ED when a young new paramedic crew brings in a post cardiac arrest that they are resuscitating. They tell you that the patient collapsed at home during a family event and that a family member immediately started CPR while the rest of the family bore witnesses.  The family is now en route to the ED and the paramedics are concerned that they did the wrong thing by allowing the family to watch. Questions: Does offering a relative the choice of observing cardiopulmonary resuscitation (CPR) reduce the likelihood of PTSD-related symptoms? Does family presence during CPR affect medical efforts at resuscitation, or well-being of the health care team? Does family presence change the occurrence of...

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SGEM#46: Don’t Pass the Dutchie (Cannabinoid Hyperemesis Syndrome)

Posted by on Sep 30, 2013 in Featured, GastroIntestinal, Podcasts, Psychiatric | 0 comments

Podcast Link:SGEM#46 Date:  September 27, 2013 Title: Don’t Pass the Dutchie from the Left Hand Side Case Scenario: 22yo man presents for the third time in a week with vomiting. He was worked up extensively in the previous two visits and no cause was found. Nothing seems to stop the vomiting. He has a similar bout of cyclical vomiting a few months ago. You go to assess him and he is very anxious and all he want to do is take a hot shower. Question:  How do you diagnose cannabinoid hyperemesis syndrome? Background: Marijuana is the number one illegal drug used in the USA and the world with psychoactive and physiologic effects. This podcast will not discuss the legality of marijuana or former presidents who apparently did not inhale. The title song “Pass the Dutchie” was a huge reggae song by British band Musical...

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SGEM#45: Vitamin H (Haloperidol for Psychosis)

Posted by on Sep 22, 2013 in Featured, Podcasts, Psychiatric | 3 comments

Podcast Link:SGEM45 Date:  September 20, 2013 Title: Vitamin H – Haloperidol Guest Skeptic: Dr. Anthony (Tony) Seupaul, Chair of EM, University of Arkansas Case Scenario: 23 yr man with schizophrenia presents with police after being picked up for violent outburst at a coffee shop. He is clearly agitated and you need to chemically restrain him. Question:  Is haloeridol the safest and most effective method of tranquilization for patients with psychosis induced aggression or agitation? Serious Reactions (from Epocrates) and delivered by Dr. Michael del Castillo-Hegyi (Chief Resident AUMS): Neurologic (extrapyramidal, tardive dyskinesia, akithisia, dystonia and seizure) Hyperpyrexia or heat stroke Neuroleptic Malignant Syndrome Pneumonia Hypotension or hypertension Cardiac (see Keener Kontest) Sudden Death Hyponatremia Hepatic impairment Hematologic (leukopenia, neutropenia and agranulocytosis) Ocular (cataracts and retinopathy) Reference: Powney MJ et al. Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). Cochrane Database of Systematic Reviews  2012,...

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