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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#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#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#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