First10EM Journal Club: December 2023
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
3M ago
Welcome to another episode of the Emergency Medicine Journal Club with Dr Justin Morgenstern. This month we cover a bunch of papers that look at a lot of topics and try to answer questions such as: Can I push Keppra safely? Does BP management in haemorrhagic stroke matter? How good is my intuition about PE diagnosis? Is it a good idea to keep geriatric patients in the ED overnight? (SPOILER: it is not), Does cryoprecipitate save lives in trauma? Should we X-ray children to diagnose constipation (SPOILER: We should not!). Are you being irradiated by the portable Xray machines in your ED? As alw ..read more
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Massive Haemorrhage: Science and Practice
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
4M ago
This is another lecture by the always amazing Dr Justin Morgenstern from the series of talks he delivered on his tour of Perth in September 2023. In this talk I challenged Justin to go on a very deep dive into the literature around the modern management of the massively bleeding trauma patient. What is the best way to resuscitate and replace all those blood products in these severely unwell people? This was a huge undertaking, Justin magaged to distill all the data into a talk that covers the science (scant as it may be) and the practical application of the numbers at the bedside (or roadside ..read more
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Decision Rules are Destroying Medicine
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
5M ago
Controversial title… courtesy of Dr Justin Morgenstern. In this podcast Justin tells me about the evidentiary basis for our modern obsession with clinical decision rules and tools. We discuss the reasons that these tools may seem like a great idea, the reality of practice and how we may be able to do better in the future. So if you have ever used a decision tool in the ED – Wells, Ottawa, PECARN, San Francisco, HEART…. or any other acronym you need to stop and have a listen to understand what these tools do, and do not achieve ..read more
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First10EM LIVE podcast: October 2023
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
5M ago
This is a very special episode of the Broome Docs Podcast Journal Club with Dr Justin Morgenstern. Justin was invited to visit us in Western Australia as a guest lecturer for the W.G. Smith lecture series. So we decided to invite along a few of our favourite FOAMed friends to be a part of the festival of nerdiness and record a live version in front of the local crew. We were joined by: Dr James Rippey (@theSonoCave) , Dr Michelle Johnson (@eleytherius), Dr Tom Cassidy (@tgpcassidy ) and Dr Alexandra Rowell (Intensivist & liver fan girl). As always – the free PDFs are linked to the titles ..read more
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How Good is Gestalt?
Broome Docs | Medical education blog for rural GP
by Casey Parker
7M ago
If you are a listener to the Journal Club podcast with Justin, then you will know that we talk a lot about decision-rules and diagnostic tests. The subject of “clinician gestalt” comes up a lot. Although the original meaning of gestalt has been lost – we all know what it is that we are talking about… We all think we have some degree of “spider sense” when it comes to picking the big, bad diseases in the Emergency Department. But do we really? Can we actually rely on that little voice inside our heads when it comes to making the right calls? Which patient should we run through the CT-of-truth ..read more
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First10EM Journal Club: June 2023
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
10M ago
Hi All, we are back with another instalment of the Journal Club with Justin Morgenstern. Big news this month is that Justin has just been invited to visit my home shop as the honorary WG Smith Fellow and deliver a series of EBM lectures to the local teams in Western Australia. So we are planning to take this show on th eraod and do some live sessions later in 2023. If you are in WA and would like to hear the nerdiness live then stay in touch and we will have updates. This episode covers herbs that may heal sepsis, drugs that probably don’t help in Covid, we ask: do steroids help in pneumonia ..read more
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First10EM Journal Club: April 2023
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
1y ago
We are back with the long-windiest and borderline funny Emergency Medicine journal club to date. Justin and I are covering some big new trials, some old and unusual papers and a few that just might change your practice. As always the links to the papers are in the write up below and you definitely should read them rather than believe a couple of nerds amusing themselves upon the internet. Enjoy. Casey The CLOVERS trial: National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, et al. Early Restricti ..read more
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Broomedocs on the SGEM: Biliary US in the ED
Broome Docs | Medical education blog for rural GP
by Casey Parker
1y ago
Welcome back. This month I am working on a few projects and have just made a guest appearance on the excellent SGEM podcast discussing a new, novel paper about the role of clinician-performed biliary ultrasound in the ED. You can read the paper here: Hilsden R, Mitrou N, Hawel J, et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022;7:e000944. You can hear the podcast here: The Skeptics Guide to Emergency Medicine... Let me know what you think. Casey ..read more
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First10EM Journal Club: January 2023
Broome Docs | Medical education blog for rural GP
by Casey Parker, Dr Casey Parker
1y ago
We are back with another episode of the BroomeDocs and First10EM podcast. In this episode we try to answer some of the big questions in Emergency Medicine, we also answer a few that you probably would never have thought to ask! Like… How much electricity should we use in refractory VF? Should we suck clots out of legs? Should you put Tegaderm on eyeballs? Is the HEART score valid? Are any clinical decision tools really what we think? What happens if you discharge patients with low troponin rise? Should you evert the edges of the wounds? Can we send kids home with abnormal vital signs? Does ki ..read more
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Broomedocs is on the SGEM: RePHILL Trial
Broome Docs | Medical education blog for rural GP
by Casey Parker
1y ago
This week I am making a guest appearance on my Canadian mate Ken Milne’s amazing podcast. Below is the written version of the chat we had about the recent RePHILL trial: prehospital blood products for shocked trauma patients. If you are not already subscribed – please go over to the Skeptics Guide to Emergency Medicine to hear the banter and subscribe to this amazingly frequent and thorough resource. Reference: Crombie et al. Resuscitation with blood products in patients with trauma-related haemorrhagic shock receiving prehospital care (RePHILL): a multicentre, open-label, randomised, con ..read more
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