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The SGEM Paper in a Pic

Kirsty Challen

Dr. Kirsty Challen

Dr. Kirsty Challen (@KirstyChallen) is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals Trust (North West England). She did 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 has a knowledge translation project called Paper In A Pic (#PaperinaPic). She takes a paper we have critically reviewed on the SGEM and summarizes it into an infographic.

Below is a list of papers, SGEM critical reviews and Kirsty’s #PaperinaPic.

Remember to be skeptical of anything you learn, even if you heard it on the Skeptics’ Guide to Emergency Medicine.

SGEM#199: Therapeutic Hypothermia – What is it Good For? Legriel et al. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. NEJM Dec 2016

199 Hypothermia

SGEM#198: Better Slow Down – Push vs. Short Infusion of Low Dose Ketamine for Pain in the Emergency Department. Motov S et al. A Prospective Randomized, Double-Dummy Trial Comparing Intravenous Push Dose of Low Dose Ketamine to Short Infusion of Low Dose Ketamine for Treatment of Moderate to Severe Pain in the Emergency Department. AJEM 2017.

198 Ketamine slow or fast

SGEM#197: Die Trying – Intubation of In-Hospital Cardiac Arrests. Andersen et al. Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival. JAMA 2017

 197 IHCA intubation

SGEM#196: Gastroparesis – I Feel Like Throwing Up. Roldan et al. Trial Comparing Haloperidol Combined With Conventional Therapy to Conventional Therapy Alone in Patients With Symptomatic Gastroparesis. AEM November 2017

196 Haldol gastroparesis

SGEM#195: Some Like It Hot – ED Temperature and ICU Survival. Sundén-Cullberg et al. Fever in the Emergency Department Predicts Survival of Patients With Severe Sepsis and Septic Shock Admitted to the ICU. Critical Care Medicine 2017.

Temperature and Sepsis

SGEM#194: Highway to the Dexamethasone – For Pediatric Asthma Exacerbations. Cronin JJ et al. A Randomized Trial of Single-Dose Oral Dexamethasone Versus Multidose Prednisolone for Acute Exacerbations of Asthma in Children Who Attend the Emergency Department. Ann Emerg Med 2016

Dex for peds asthma

SGEM#193: Stop, In the Name of Love. Harrison et al. Sweet Solutions to Reduce Procedural Pain in Neonates: A Meta-analysis. Pediatrics 2017

sweet solutions

SGEM#192: Sometimes, All You Need is the Air that You Breathe. Hofmann et al. Oxygen Therapy in Suspected Acute Myocardial Infarction. NEJM Sept 2017.

Oxygen STEMI

SGEM#191: No Time for Physio – Roll With It. Brison et al. Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial. BMJ Nov 2016.

SGEM#190: Wee are the Champions of Pediatric Urine Samples. Kaufman, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ April 17.

Quick Wee

SGEM#189: Bring Me To Life in OHCA. Cournoyer et al. Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. Academic Emergency Medicine. September 2017.

SGEM#188: Icatibant Bites the Dust – For ACE-I Induced Angioedema. Sinert et al. Randomized Trial of Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Upper Airway Angioedema. J Allergy Clin Immunol Pract 2017.


SGEM#187: Pin Cushion – Acupuncture in the Emergency Department. Cohen et al. Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial. MJA 2017


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

Apneic Oxygenation Paperinapic

SGEM#185: Every EHR Wants to “Rule” the World. Bookman K et al. Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High-cost Imaging in the Emergency Department: EmbED study. AEM July 2017.

Embedded CDS tools

SGEM#184: We Weren’t Born to Follow-Up – The PEITHO Long-Term Follow-up Study. Konstantinides et al. Impact of Thrombolytic Therapy
 on the Long-Term Outcome of Intermediate-Risk Pulmonary Embolism. JACC March 2017.

PEITHO long term

SGEM#183: Don’t RINSE, Don’t Repeat. Bernard et al. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline
The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016.


SGEM#182: Platelet Transfusions for Intracerebral Hemorrhage (PATCH) – Don’t Do It. Baharoglu et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016.


SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind? 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.

REACT-2 paperinapic

SGEM#180: The First Cut is the Deepest – N.O.T. for Paediatric Appendicitis. Georgiou et al. Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis. Pediatrics 2017.


SGEM#178: Mindfulness – It’s not Better to Burnout than it is to Rust. Ireland et al. A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher 2017.


SGEM#179: Chase the Dragon and Naloxone. Willman et al. Do heroin overdose patients require observation after receiving naloxone? Clinical Toxicology 2017.

SGEM#177: POCUS – A New Sensation for Diagnosing Pediatric Fractures. Poonai et al. Point-of-care ultrasound for non-angulated distal forearm fractures in children: test performance characteristics and patient-centered outcomes. Acad Emerg Med May 2017.

POCUS paperinapic

SGEM#176: Somebody’s Watching Me – Cardiac Monitoring for Chest Pain. Syed et al. Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring. CMAJ Jan 2017

Ottawa CPCM Paperinapic

SGEM#175: Dancing on the Ceiling with Ketorolac for Pain. Motov et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med Dec 2016

torodol Paperinapic

SGEM#174: Don’t Believe the Hype – Vitamin C Cocktail for Sepsis. Marik et al. Hydrocortisone, Vitamin C and Thiamine for the Treatment of Severe Sepsis and Septic Shock: A Retrospective Before-After Study. Chest Dec 2016.

Vitamin C

SGEM:173: Diazepam Won’t Get Back Pain Down. Friedman BW et al. Diazepam is no better than placebo when added to naproxen for acute low back pain. Ann Emerg Med 2017.

Diazepam for back pain

SGEM#172: Don’t Bring My Blood Pressure Down (Intensively) – The ATACH2 Trial. Qureshi et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. NEJM June 2016


SGEM#171: Step-by-Step Approach to the Febrile Infant. Gomez et al. Validation of the “Step-by-Step” Approach in the Management of Young Febrile Infants. Paediatrics July 2016

Step by step paterinapic

SGEM#170: Don’t Go Breaking My Heart – Ottawa Heart Failure Risk Scale. Stiell et al. Prospective and Explicit Clinical Validation of the Ottawa Heart Failure Risk Scale, With and Without Use of Quantitative NT-proBNP. AEM March 2017

Paperinapic OHFRS

SGEM#169: Stuck in the Middle with Food (Glucagon for Esophageal Foreign Body Impaction). Bodkin et al. Effectiveness of glucagon in relieving esophageal foreign body impaction: a multicenter study. AJEM June 2016


SGEM#168: HYPRESS – Doesn’t Got the Power. Keh D et al. Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis: The HYPRESS Randomized clinical Trial. JAMA 2016

HYPRESS paperinapic

SGEM#167: The Management of Bronchiolitis in Community Hospitals. Plint et al. Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study. CJEM November 2016

SGEM#166: Which febrile child with sickle cell disease should get a chest x-ray? Eisenbrown et al. Which Febrile Children with Sickle Cell Disease Need a Chest X-Ray? AEM November 2016.

SGEM#165: I Wanna Be Sedated – But Do I Need To Be NPO? Beach et al. Major Adverse Events and Relationship of Nil per Os Status in Pediatric Sedation/Anesthesia Outside the Operating Room. Anesthesiology January 2016


SGEM#164: Cuts Like a Knife – But you Might Also Need Antibiotics for Uncomplicated Skin Abscesses. Talan et al. Trimethoprim–Sulfamethoxazole versus Placebo for Uncomplicated Skin Abscess. NEJM March 2016.

SGEM#163: Shuffle off to Buffalo to Talk Thrombolysis for Acute Pulmonary Embolism. 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 Aug 2015


SGEM#162: Not Stayin’ Alive More Often with Amiodarone or Lidocaine in OHCA. Kudenchuk et al. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. NEJM April 2016


SGEM#161: Sternal Fractures – Break on Through to the Other Side – Delayed Complications and Functional Outcomes. Racine et al. Delayed complications and functional outcome of isolated sternal fracture after emergency department discharge: a prospective, multicentre cohort study. CJEM Sept 2016


SGEM#160: Oh Baby, You’re Too Sensitive – High Sensitivity Troponin. Body et al. The use of very low concentrations of high sensitivity troponin T to rule out acute myocardial infarction using a single blood test. AEM Sept 2016

: Computer Games – Computer Provider Order Entry (CPOE). Gray A et al. The impact of computerized provider order entry on emergency department flow. CJEM 2016

paperinapic CPOE

SGEM#158: Tempted by the Fruit of Another – Dilute Apple Juice for Pediatric Dehydration. Freedman et al. Effect of dilute apple juice and preferred fluids vs. electrolyte maintenance solution on treatment failure among children with mild gastroenteritis: A randomized clinical trial. JAMA 2016

Apple Juice

SGEM#157: Nebulized Hypertonic Saline for Acute Bronchiolitis. Zhang et al. Nebulized Hypertonic Saline for Acute Bronchiolitis: A Systematic Review. Pediatrics 2015

hypertonic Saline Bronchiolitis

SGEM#156: Working at the Abscess Wash – Irrigation of Cutaneous Abscesses? Chinnock and Hendey. Irrigation of Cutaneous Abscesses Does Not Improve Treatment Success. Ann Emerg Med 2016

Abscess Irrigation

SGEM#155: Girls Just Want To Have Fun – Not Appendicitis. Scheller et al. Utility of Pediatric Appendicitis Score in Female Adolescent Patients. AEM 2016

Ped Appendicitis Score

SGEM#154: Here I Go Again, Kidney Stone. Pickard et al. Medical expulsive therapy in adults with ureteric colic: a multicentre, randomised, placebo-controlled trial. Lancet 2015Furyk et al. Distal Ureteric Stones and Tamsulosin: A Double-Blind, Placebo-Controlled, Randomized, Multicenter Trial. Annals of EM 2016

Renal Colic

Renal colic Tamsulosin or nifedipine

SGEM#153: Simulation for Ultrasound Education. Olszynski et al. Ultrasound during Critical Care Simulation: A Randomized Crossover Study. CJEM 2016

Simulation for POCUS

SGEM#152: Movin’ on Up – Higher Floors, Lower Survival for OHCA. Drennan et al. Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival. CMAJ 2016

OHCA Highrise

SGEM#151: Groove is in the HEART Pathway. Mahler SA et al. The HEART Pathway Randomized Trial Identifying Emergency Department Patients with Acute Chest Pain for Early Discharge. Circ Cardiovasc Qual Outcomes 2015


SGEM#150: Hypertonic Saline for Traumatic Brain Injury. Pelletier et al. Hypertonic saline in severe traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials. CJEM 2016

Hypertonic Saline TBI

SGEM#147: This is a SVT and I’m Gonna REVERT It – Using a Modified Valsalva Manoeuvre. Appelboam et al. Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial. Lancet 2015


SGEM#146: The HEAT is On – IV Acetaminophen for Fever in the ICU. Young P et al. Acetaminophen for Fever in Critically Ill Patients with Suspected Infection. NEJM 2015

HEAT IV acetaminophen

SGEM#144: That Smell of Isopropyl Alcohol for Nausea in the Emergency Department.  Beadle, et al. Isopropyl alcohol nasal inhalation for nausea in the emergency department: a randomized controlled trial. Ann Emerg Med 2015

Isopropyl Alcohol for Nausea

SGEM#143: Call Me Maybe for Bystander CPR. Ringh et al. Mobile-Phone dispatch of Laypersons for CPR in Out-of-Hospital Cardiac Arrest. NEJM 2015

Smart Phone CPR

SGEM#139: One Thing Leads to Another – Idarucizumab for Dabigatran Reversal? Pollack CV et al. Idarucizumab for Dabigatran Reversal. NEJM 2015

Dabigatran Reversal

SGEM#138: Hip to be Blocked – Regional Nerve Blocks for Hip and Femoral Neck Fractures. Ritcey et al. Regional Nerve Blocks for Hip and Femoral Neck Fractures in the Emergency Department: A Systematic Review. CJEM 2015

Regional hip block

SGEM#135: The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen. Frat JP et al. High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure. NEJM 2015

Hi Flow Nasal O2

SGEM#134: Listen, to what the British Doctors Say about LPs post CT for SAH. Sayer et al. An Observational Study of 2248 Patients Presenting with Headache, Suggestive of Subarachnoid Hemorrhage, that Received a Lumbar Puncture Following a Normal CT Head. Acad Emerg Med 2015

LP post CT for SAH

SGEM#133: Just Beat It (Atrial Fibrillation) with Diltiazem or Metoprolol? Fromm C et al. Diltiazem vs. metoprolol in the management of atrial fibrillation or flutter with rapid ventricular rate in the emergency department. J Emerg Med 2015Rate control Afib.

SGEM#131: Gimme Some Antibiotics for Uncomplicated Skin Infections. Miller LG, et al. Clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated skin infections. NEJM 2015

Antibiotics for cellulitis

SGEM#130: Low Dose Ketamine for Acute Pain Control in the Emergency Department. Motov et al. Intravenous Subdissociative-Dose Ketamine Versus Morphine for Analgesia in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med 2015Beaudoin et al. Low-dose ketamine improves pain relief in patients’ receving intravenous opiods for acute pain in the emergency department: results of a randomized, double-blind, clinical trial. Acad Emerg Med 2014

Ketamin Motov

Ketamine Beaudoin

SGEM#129: That Chest Tube…She’s a Beauty. Kong et al. What is the yield of routine chest radiography following tube thoracostomy for trauma? Injury 2015

CXR after Chest Tube

SGEM#127: Suspicious Minds vs. Clinical Prediction Rule in Children with Trauma. Mahajan P et al. Comparison of clinical suspicion versus a clinical prediction rule in identifying children at risk for intra-abdominal injuries after blunt torso trauma. Acad Emerg Med 2015

Ped blunt ab trauma

SGEM#124: Ultrasound for Skull Fractures – Little Bones. Rabiner JE et al. Accuracy of point-of-care ultrasound for diagnosis of skull fractures in children. Pediatrics 2013

POCUS for Ped Skull Fractures