SGEM Xtra: ASMUQ Scientific Conference

Date: October 18th, 2017

Thank you to the organizing committee for inviting me to Montreal to present at the ASMUQ annual conference. It was wonderful to see existing friends and make a few new friends.

The first talk was called The Medical Myth Menace. It addressed six emergency medicine myths by reviewing six recent publications. For each myth some background information was provided, a specific clinical question was asked, the P.I.C.O. (population, intervention, control/comparison, outcome) was reviewed, key results given, the bottom line stated and how you could apply this information clinically.

Movie Crawler

The presentation had a Star Was theme and started with a video crawler in French. Clink on the thumbnail to watch the movie crawler opening. Thank you to Marcel Emond from SGEM Global French for translating the English into French.

The six emergency medicine myths came from six previous SGEM episodes. Here are the six myths, the conclusions and a link to the SGEM critical review:

ED Myth #1: A lumbar puncture is needed post negative CT to rule out subarachnoid hemorrhage.
- In this study, one patient would be diagnosed with SAH out of every 250 patients receiving a LP who presented to the emergency department with a headache that did not have their bleed identified on CT scan. SGEM#134
ED Myth #2: Mesa thinks ACLS works for out-of-hospital cardiac arrest (OCHA).
- Even in E-CPR candidate patients, there is no evidence that ACLS provides a patient oriented benefit. SGEM#189
ED Myth #3: Apneic oxygenation for rapid sequence intubation
- Apneic oxygenation may still have a role during rapid sequence intubation of emergency department patients but it likely adds little when proper pre-oxygenation strategies are used. SGEM#186
ED Myth #4: Pediatric gastroenteritis – I have to drink what?
- When advising parents with children with mild gastroenteritis and minimal dehydration, offering half-strength apple juice and preferred fluids compared to electrolyte solutions is a better choice. SGEM#158
ED Myth #5: Therapeutic hypothermia for out-of-hospital cardiac arrests (OCHA).
- We do not have good evidence that providing pre-hospital cooling to patients with OHCA receiving CPR has a patient oriented benefit and therefore cannot be recommended at this time. SGEM#183
ED Myth #6: An observational study proves vitamin C can cure sepsis.
- Vitamin C, hydrocortisone and thiamine was associated with lower mortality in severe septic and septic shock patients in this one small, single centre retrospective before-after study but causation has yet to be demonstrated. SGEM#174

The second talk was called Evidence Based Medicine (EBM) and Knowledge Translation (KT) at the Speed of Social Media. During the talk EBM, KT and social media were defined. The problem with knowledge translation was explained using the Leaky Pipe Model. Social media was offered as a possible solution for the KT problem. A few different types of social media were discussed. The story behind the #FOAMed movement was provided. Common criticisms of social media were reviewed going all the way back to 4th Century BCE. Some good #FOAMed sites were suggested. Further reading on how to get started on social media was provided, how use it professionally and how to critically appraise blogs and podcasts.

In the end, it was demonstrated that social media has shrunk the world and can shorten KT window from over ten years to less than one year. This is so patients can get the best care based on the best evidence.

Never before have doctors had access to worlds best evidence so easily and so quickly. It is like we are holding the world’s medical knowledge in the palm of our hand.

All of the slides from these two presentation are available by clicking on the thumbnail pictures.