SGEM#206: I’m Wheezy Like A Pre-Schooler – Prednisolone for Wheezy Children
Podcast Link: SGEM206a Date: February 6th, 2018 Reference: Foster SJ et al. Oral prednisolone in preschool children with virus-associated wheeze: a prospective, randomised, double-blind, placebo-controlled trial. Lancet January 2018 Guest Skeptic: Dr. Tessa Davis is a Pediatrician specialising in Pediatric Emergency Medicine and currently practicing in a central London hospital. She is also the co-founder of Don’t Forget the Bubbles and on the FeminEM Speaker Bureau. Case: Tom is a 4-year-old boy who comes into the emergency department with a wheeze following a viral illness. He has been taking salbutamol at home today but he’s still not improving. He has mild work of breathing and a bilateral wheeze. His oxygen saturation is 94% on room air. Tom has no other previous medical history. You start to write up the salbutamol, but should you give him a dose of prednisolone too? Background: We see “little wheezers”...
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SGEM#203: Let Me Clear My Sore Throat with a Corticosteroid
Podcast Link: SGEM203 Date: January 15th, 2018 Reference: Sadeghirad B, et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials. BMJ 2017 Guest Skeptic: Meghan Groth is an Emergency Medicine Pharmacist at the UMass Memorial Medical Center in Worcester, Massachusetts. She has contributed to the Academic Life in Emergency Medicine and EM PharmD blogs, and is a part of the ALiEM Capsules Team. Case: 50-year-old man presents with a one day history of sore throat, cough and low-grade fever. He is otherwise healthy with only sports related injuries. The ibuprofen did not help and he is requesting antibiotics so he can get back to work sooner. Background: Patients present commonly to their primary care providers (PCPs) and to the emergency department (ED) with complaints of a sore throat. In the US, adults accounted for 6.6 million visits...
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SGEM#186: Apneic and the O, O, O2 for Rapid Sequence Intubation
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
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
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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