SGEM#179: Chase the Dragon and Naloxone
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
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?
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?
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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SGEM#163: Shuffle off to Buffalo to Talk Thrombolysis for Acute Pulmonary Embolism
Podcast Link: SGEM163 Date: October 6th, 2016 Reference: Piazza et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism. JACC 2015 Guest Skeptic: Dr. Essie Reed is one of the Chief Residents in the Department of Emergency Medicine at the University of Buffalo. Case: A 75-year-old female with a past medical history of hypertension and non-insulin dependent diabetes presents with chest pain. She describes the pain as sharp, stabbing, and exacerbated with deep inspiration. She reports associated shortness of breath. She denies syncope, nausea, and diaphoresis. The pain has been present for one week, and is nearly constant. She reports that she traveled to Florida to visit her grandchildren three weeks ago. She has no fever, chills, cough, or sputum production. She is complaining of ongoing chest pain, 5/10, increased to 7/10 when asked...
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SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes
Podcast Link: SGEM161 Date: September 21st, 2016 Reference: Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 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: A 49-year-old male presents to the emergency department after being in a motor vehicle collision. You diagnose him with an isolated sternal fracture on X-ray. Specifically there are no rib fractures or lung abnormalities identified. He also has a normal ECG and troponin. As you are preparing to discharge him, he asks if there are...
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