Pages Navigation Menu

Meet 'em, greet 'em, treat 'em and street 'em

SGEM#163: Shuffle off to Buffalo to Talk Thrombolysis for Acute Pulmonary Embolism

Posted by on Oct 10, 2016 in Cardiac, Featured, Podcasts, Pulmonary | 2 comments

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...

Read More

SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes

Posted by on Sep 25, 2016 in Featured, Podcasts, Pulmonary, Trauma | 9 comments

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...

Read More

SGEM#142: We Need Asthma Education

Posted by on Jan 10, 2016 in Featured, Podcasts, Pulmonary | 24 comments

Podcast Link: SGEM142 Date: January 5th, 2016 Guest Skeptics: Dr. Chris Carpenter is from Washington University, Deputy Editor of Academic Emergency Medicine and faculty member of Emergency Medical Abstracts. Dr. Brian Rowe is a Professor, Department of Emergency Medicine, at the University of Alberta. He is a Canadian Research Chair in Evidence-Based Emergency Medicine and is also co-editor of the Cochrane Collaboration Airway Review Group. Dr. Cristina Villa-Roel is a physician with a MSc in Clinical Epidemiology who is nearing the completion of her PhD at the School of Public Health at the University of Alberta. She is interested in improving the quality of life for patients with asthma by coordinating transitions in care between the emergency department and the primary care setting through the delivery of comprehensive and evidence-based care. Her research is supported by the Canadian Institutes for Health Research (CIHR)...

Read More

SGEM#135: The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen

Posted by on Nov 8, 2015 in Cardiac, Featured, Podcasts, Pulmonary | 1 comment

Podcast Link: SGEM135 Date: October 28th, 2015 Guest Skeptic: Dr. Justin Morgenstern. Justin is an emergency physician and the director of simulation education at Markham Stouffville Hospital in Ontario. He loves skepticism and medical education, especially when it is free and open access. He is the author of the #FOAMed blog First10EM.com and is an associate editor of Emergency Medicine Cases. Case: A 60-year-old male with no major past medical history presents to your community emergency department with a three-day history of cough, fever and increasing shortness of breath. He is tachypneic with a respiratory rate of 28 and an oxygen saturation of 89% despite facemask oxygen, but he is mentating normally. Your Respiratory Therapist asks you whether you want her to try the new high flow nasal oxygen machine we have? Background: High flow nasal oxygen is a novel device that actively...

Read More

SGEM#129: That Chest Tube…She’s a Beauty

Posted by on Sep 27, 2015 in Featured, Podcasts, Pulmonary, Trauma | 4 comments

Podcast Link: SGEM129 Date: August 14th, 2015 Guest Skeptics: Dr. Rick Malthaner is the Director of Thoracic Surgery Research, Professor of Surgery, Epidemiology and Biostatistics at the Schulich School of Medicine and Dentistry, Western University, Canada. Case: A 25 year old female was allegedly stabbed while standing on the corner minding her own business. She was found unconscious (Glasgow Coma Scale 7) and was intubated by the EMS. On arrival in your emergency department, the vitals are stable, but there is decreased air entry on the right side. You skillfully insert a right chest tube and get back 100 ml of blood. You review the post insertion chest tube x-ray and are somewhat disappointed by the position of your tube. It is hitting the mediastinum and curling back on itself and there is persistent white-out on the right. Background: The “B” of...

Read More

SGEM#126: Take me to the Rivaroxaban – Outpatient treatment of VTE

Posted by on Jul 5, 2015 in Cardiac, Featured, Podcasts, Pulmonary | 18 comments

Podcast Link: SGEM126 VTE Date: July 2nd, 2015 Guest Skeptic: Dr. Jeffrey Kline (@klinelab) is the Vice Chair of Research in Emergency Medicine and a professor of physiology, Indiana University School of Medicine. Most of you probably know him as the origin of the PERC Rule.  His diagnostic research interests focus on human affect analysis, pretest probability and capnography to reduce medical imaging. His human treatment research includes randomized trials of fibrinolysis and inhaled nitric oxide. His laboratory work focuses on mechanisms and treatment of acute pulmonary hypertension from pulmonary embolism, animal models of pulmonary embolism, and nanoparticle-delivered plasmin for clot lysis. Case: A 55 year old man presents with chest pain and shortness of breath. You risk stratify him to be non-high risk. His d-dimer comes back elevated at 720. A CT scan confirms a segmental pulmonary embolism. Background:...

Read More