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SGEM#186: Apneic and the O, O, O2 for Rapid Sequence Intubation

Posted by on Sep 3, 2017 in Featured, Podcasts, Pulmonary | 5 comments

Podcast Link: SGEM186 Date: September 2nd, 2017 Reference: Caputo et al. EmergeNcy Department use of Apneic Oxygenation versus usual care during rapid sequence intubation: A randomized controlled trial (The ENDAO Trial). AEM 2017. Guest Skeptic: Dr. Rory Spiegel is a clinical instructor at University of Maryland and a recent graduate of Stony Brook’s Resuscitation Fellowship. He writes an excellent blog called EM Nerd, which he describes as nihilistic ramblings. Case: A 68-year-old female presents with shortness of breath. She has experienced fever, chills and a productive cough worsening over the past five days. Chest X-ray demonstrated bilateral infiltrates consistent with multifocal pneumonia. Over her emergency department course the patients starts to decompensate despite high-flow nasal cannula and broad-spectrum antibiotics.  The decision is made to intubate the patient. The question arises whether apneic oxygenation should be used during the rapid sequence intubation. Background: Much...

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SGEM#184: We Weren’t Born to Follow-Up – The PEITHO Long-Term Follow-up Study

Posted by on Jul 2, 2017 in Cardiac, Featured, Hematologic, Podcasts, Pulmonary | 1 comment

Podcast Link: SGEM184 Date: June 21st, 2017 Reference: Konstantinides et al. Impact of Thrombolytic Therapy
 on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017 Guest Skeptic: Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did her Medical School at Manchester, with a History of Medicine BSc at the same time. Kirsty did her residency in North West England and has a PhD in Health Services Research from Sheffield. Kirsty is also the creator of a knowledge translation project called #PaperinaPic. Case: A 22-year-old patient presents to the emergency department with sudden onset shortness of breath. She takes the oral contraceptive pill and was placed in a below-knee plaster cast for a fibula fracture 2 weeks ago. She is alert and talking, with a systolic blood pressure of 110 mmHg, but CTPA...

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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#167: The Management of Bronchiolitis in Community Hospitals

Posted by on Dec 18, 2016 in Featured, Infectious, Pediatrics, Podcasts, Pulmonary | 12 comments

Podcast Link: SGEM167 Date: December 14th, 2016 Reference: Plint et al. Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study. CJEM November 2016 Guest Skeptic: Dr. Chris Bond. Chris 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: Parents present to your community emergency department with their 6-month-old daughter. She has had a cough, fever, and “noisy breathing” for the past 24 hours. She is otherwise healthy, having had a previously uncomplicated prenatal, delivery, and post-natal course. Her immunizations are up to date. There is no family history of atopy or asthma. On exam she is febrile at...

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SGEM#166: Which febrile child with sickle cell disease should get a chest x-ray?

Posted by on Dec 4, 2016 in Featured, Hematologic, Pediatrics, Podcasts, Pulmonary | 15 comments

Podcast Link: SGEM166 Date: November 21st, 2016 Reference: Eisenbrown et al. Which Febrile Children with Sickle Cell Disease Need a Chest X-Ray? AEM November 2016 Guest Skeptic: Dr. Corey Heitz is an associate professor of emergency medicine at the Virginia Tech Carilion School of Medicine 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. Case: You are working in the Emergency Department on an overnight pediatric coverage shift. A worried mother brings her 2-year-old child in with a fever of 38.6C (that’s 101.5F). The female child’s medical history is significant for sickle cell disease. On exam, the child is uncomfortable appearing, tachycardic, tachypnic and febrile. Mom says the child has had a runny nose and a mild cough along with the fever. Background: Children with sickle...

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SGEM#165: I Wanna Be Sedated – But Do I Need To Be NPO?

Posted by on Nov 27, 2016 in Featured, Pediatrics, Podcasts, Pulmonary | 4 comments

Podcast Link: SGEM165 Date: November 22nd, 2016 Reference: Beach et al. Major Adverse Events and Relationship of Nil per Os Status in Pediatric Sedation/Anesthesia Outside the Operating Room. Anesthesiology January 2016 Guest Skeptic: Dr. Bob Edmonds has just completed his residence in Emergency Medicine from the University of Missouri in Kansas City. He is now an emergency department staff physician in the US Air Force at Langley Air Force Base. Dr. Edmonds’ Disclaimer: The views and opinions of this podcast and blog are not the official position of the United States Air Force, the US government, or Langley Air Force Base. Thanksgiving: This episode is being published on American Thanksgiving 2016 weekend. Happy Thanksgiving to all the SGEMers from the USA. We hope everyone has a wonderful holiday spent with family and friends. Case: A 5-year-old girl was bit in the face...

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