SGEM#212: Holding Back the Years – Risk Factors for Adverse Outcomes in Older Adults with Blunt Chest Trauma
Podcast Link: SGEM212 Date: March 20th, 2018 Reference: Sawa et al. Risk factors for adverse outcomes in older adults with blunt chest trauma: A systematic review. CJEM March 2018 Guest Skeptic: Dr. Christina Shenvi is an Emergency Physician at University of North Carolina. She is fellowship trained in Geriatric Emergency Medicine and has a podcast called GEMCAST. Christina loves serving as the assistant residency director, writing things, reading things, teaching people, and having kids. Case: An 85-year-old woman with a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), and type-2 diabetes (DM-2), and her 65-year-old otherwise healthy daughter present to the emergency department after a car accident. It was a low speed motor vehicle collision (MVC) in which they rear-ended a stationary car. However, they were both unrestrained. They both have a Glasgow Coma Scale (GCS) of 15 on arrival and...
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SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?
Podcast Link: SGEM181 Date: June 3rd, 2017 Reference: Sierink et al. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Lancet August 2016. Guest Skeptic: Dr. Marcel Emond is an Associate Professor, Laval University, Emergency Physician at the Level 1 Trauma Center of the CHU de Québec, a Senior Clinician-Scientist, Chair of CAEP Trauma and Injury prevention committee, BEEM faculty member and the host of SGEM Global French. Case: A 53-year-old woman in good health is brought in by ambulance after a motor vehicle collision. She did not lose consciousness but did bump her head. Her main complaint is chest pain with difficulty breathing. She is tachycardic, tachypnic and has some mild abdominal pain. You suspect a flail chest on your clinical examination. A FAST examination is performed and is...
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SGEM Xtra: Talk Trauma 2017- Tales from the Outer Rim
Date: April 7th, 2017 Superstar Nurse Brenda Palsa and I had a wonderful time presenting at Talk Trauma 2017 this week in London, Ontario. It is a one day conference for nurses, allied health & EMS professionals involved in providing care for adult and paediatric trauma patients. Talk Trauma is put on by the London Health Science Centre (LHSC). We were honoured to return for a second year in a row to talk about managing trauma patients in the periphery. Our idea was to demonstrate that you could provide excellent evidence based care before transferring patients to the trauma centre (LHSC). This resulted in Episode II – Tales from the Outer Rim (Talk Trauma Intro Trailer). I was inspired by ZdoggMD and dress up as Doc Vader while Brenda became Nurse Leia. The entrance went well as we...
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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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SGEM#150: Hypertonic Saline for Traumatic Brain Injury
Podcast Link: SGEM150 Date: March 24th, 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). Lead Author: Dr. Elyse Pelletier. Elyse works at the Centre de Recherche CHU de Québec, Population Health and optimal Health Practices Unit. She is also in the Department of Family and Emergency Medicine, Université Laval, Québec, QC, Canada. Case: A 21-year-old male is standing on the corner, minding his own business (SOCMOB) when he is hit in the head with a bat and suffers a severe traumatic brain injury. He is brought into the trauma room and appears to have...
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SGEM#129: That Chest Tube…She’s a Beauty
Podcast Link: SGEM129 Date: August 14th, 2015 Guest Skeptic: 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 the ABCs...
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