SGEM#438: Bone, Bone, Bone, Tell Me What Ya Gonna Do – for IO Access Location?
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Tanner et al, A retrospective comparison of upper and lower extremity intraosseous access during out-of-hospital cardiac arrest resuscitation. Prehospital Emergency Care. February 2024. Date: April 25, 2024 Guest Skeptic: Missy Carter is a PA working in an ICU in the Tacoma area and an adjunct faculty member with the Tacoma Community College paramedic program. She is also the local director of the difficult airway EMS course at Washington State. Case: EMS arrives with a 58-year-old woman who suffered an out-of-hospital cardiac arrest (OOHCA). When emergency department (ED) staf ..read more
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SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Ramesh S, Ayyan SM, Rath DP, Sadanandan DM. Efficacy and safety of ultrasound-guided erector spinae plane block compared to sham procedure in adult patients with rib fractures presenting to the emergency department: A randomized controlled trial. AEM April 2024 Date: April 19, 2024 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at the NYU Grossman Long Island Hospital Campus. Case: You are doing great things and helping many patients during your shift in the emergency department (ED) when ..read more
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SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. NEJM Feb 2024 Date: April 12, 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA. He is an assistant professor in Emergency Medicine, Neurology, and Neurosurgery at the School of Medicine at the University of Washington. Case: A 70-year-old woman was brought into the emergency department by EMS after her family reported she was having trou ..read more
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SGEM #435: Don’t Stop Believing…A Vaccine can Work for RSV
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference:  Drysdale SB et al. Nirsevimab for Prevention of Hospitalizations due to RSV in Infants. N Engl J Med. 2023 Date: March 29, 2024 Guest Skeptic: Dr. Michael Cosimini is a pediatrician in Portland Oregon. He is the designer of Empiric Game, a medical editor and contributor to Pediatrics Reviews and Perspectives (PedsRAP) and the digital media editor at Academic Pediatrics. He is passionate about podcasting and serious games for medical education. Dr. Michael Cosimini Case: A 4-month-old twin girl is brought by her parents to the emergency department (ED) for respiratory distress ..read more
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SGEM#434: It’s (Un) Happy Hour Again – Mortality in Younger Patients with Alcohol-Related ED Attendances
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Harrison et al. Mortality in adolescents and young adults following a first presentation to the emergency department for alcohol. AEM March 2024. Date: March 27, 2024 Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s a Friday evening at the end of the academic year in the Paediatric Emergency Department (ED) and you are with the parents of a 15-year-old girl who has been brought in acutely intoxicated from an unofficial “School’s Out” party. Although your patient has recovered and is now fit for discharge ..read more
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SGEM#433: Breathe – Simple Aspiration vs. Drainage for Complete Pneumothorax
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Marx et al. Simple Aspiration versus Drainage for Complete Pneumothorax: A Randomized Noninferiority Trial. Am J Respir Crit Care Med. 2023 Date: March 22, 2024 Guest Skeptic: Dr. Richard Malthaner holds the prestigious position of Chair/Head of the Division of Thoracic Surgery and serves as the Director of the Thoracic Robotic Program at Western University's Schulich School of Medicine and Dentistry. Dr. Malthaner currently serves as the Vice President of the Canadian Association of Thoracic Surgeons and is the founder of the Skeptik Thoracik Journal Club. Case: A 25-year-old ..read more
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SGEM Xtra: The Matrix – Social Media for Knowledge Translation
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Date: March 16, 2024 This is an SGEM Xtra episode. Yes, that is two back-to-back SGEM Xtra episodes. The critical appraisal that was lined up for this week's episode got delayed due to some scheduling problems with clinical responsibilities. You can access all the slides for this episode from this LINK and see the presentation on YouTube. This episode is from a talk I gave a few years ago on social media for knowledge translation. How this technology could make the world a better place. I’ve come to recognize that many SGEMers are not very familiar with the best movie decade of all time, the 1 ..read more
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SGEM Xtra: A Philosophy of Emergency Medicine
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Date: March 6, 2024 This is an SGEM Xtra created from a lecture I gave for the Rural Ontario Medical Program (ROMP) ICE Camp Retreat in Collingwood, Ontario last month. ROMP helps Ontario medical students & residents arrange core & elective rotations in rural Ontario. An old friend, Dr. Matt De Stefano invited me to give a lecture to the PGY-3 Emergency Medicine Residents. Matt said it could be a talk on anything so I decided to create a new presentation called “A Philosophy of Emergency Medicine” This lecture was inspired by the wonderful Professor Melanie Trecek-King. She is a scienc ..read more
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SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY.  He is the Vice Chair of the Emergency Department at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County. Case: A 59-year-old man walks into your community emergency department (ED) complaining of chest pain. It is describ ..read more
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SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED.
The Skeptics Guide to Emergency Medicine (SGEM)
by Dr. Ken Milne
6d ago
Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. Case: A 66-year-old female with a history of smoking, hypertension, and type-2 diabetes presents to the emergency department (ED) with syncope while walking her dog. She compl ..read more
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