The Skeptics Guide to Emergency Medicine

The Skeptics Guide to Emergency Medicine episodes:

• 04.20.2024

  SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures

  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...

  
• 04.13.2024

  SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke

  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...

  
• 04.06.2024

  SGEM #435: Don’t Stop Believing…A Vaccine can Work for RSV

  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,...

  
• 03.30.2024

  SGEM#434: It’s (Un) Happy Hour Again – Mortality in Younger Patients with Alcohol-Related ED Attendances

  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...

  
• 03.23.2024

  SGEM#433: Breathe – Simple Aspiration vs. Drainage for Complete Pneumothorax

  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...

  
• 03.16.2024

  SGEM Xtra: The Matrix – Social Media for Knowledge Translation

  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...

  
• 03.09.2024

  SGEM Xtra: A Philosophy of Emergency Medicine

  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...

  
• 03.02.2024

  SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections

  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,...

  
• 02.24.2024

  SGEM#341: You Make Me Feel Like a Natural Treatment

  Reference: Li, T., & Gal, D. (2023). Consumers prefer natural medicines more when treating psychological than physical conditions. Journal of Consumer Psychology 2023, Date: February 23, 2024 Guest Skeptic: Ethan Milne is a Marketing PhD student at the Ivey Business School (Western University). He...

  
• 02.11.2024

  SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED.

  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...

  
• 02.03.2024

  SGEM #429: It’s CT Angio, Hi. I’m the Problem. It’s Me. For Pediatric Oropharyngeal Trauma

  Reference: Curry SD, et al. Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma. Laryngoscope. March 2023 Date: January 30, 2024 Guest Skeptic: Dr. Alexandra (Ali) Espinel is an Associate professor of pediatrics and otolaryngology at Children’s National Hospital...

  
• 01.27.2024

  SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in RVMI

  Reference: Wilkinson-Stokes M, Betson J, Sawyer S. Adverse events from nitrate administration during right ventricular myocardial infarction: a systematic review and meta-analysis. Emerg Med J. February 2023 Date: January 24, 2024 Guest Skeptic: Dr. Rupinder Sahsi is a fellow EBM enthusiast with academic appointments...

  
• 01.20.2024

  SGEM #427: I Want a Treatment with a Short Course…for Pediatric Urinary Tract Infections

  Reference: Zaoutis T, et al. Short-course Therapy for Urinary Tract Infections in Children: the SCOUT randomized clinical trial. JAMA Pediatr. Aug 2023 Date: October 30, 2023 Guest Skeptic: Dr. Ellie Hill is a pediatric emergency medicine physician at Children’s National Hospital in Washington,...

  
• 01.13.2024

  SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest

  Reference: Snyder BD, Van Dyke MR, Walker RG, et al. Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. Resuscitation 2023. Date: January 11, 2024 Guest Skeptic: Dr. Chris Root is an EMS fellow...

  
• 01.06.2024

  SGEM #425: Are You Ready for This? Pediatric Readiness of Emergency Departments

  Reference: Remick KE, et al. National Assessment of Pediatric Readiness of US Emergency Departments during the Covid-19 Pandemic. JAMA Netw Open. July 2023 Date: Dec 11, 2023 Guest Skeptic: Dr. Rachel Hatcliffe is a pediatric emergency medicine attending at Children’s National Hospital...

  
• 12.30.2023

  SGEM#424: Ooh-Ooh, I Can’t Wait – To Be Admitted to Hospital

  Reference: Roussel et al. Overnight stay in the emergency department and mortality in older patients, JAMA Intern Med 2023 Date: December 18, 2023 Guest Skeptic: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Case: An 85-year-old patient (Ms. McG) presents...

  
• 12.23.2023

  SGEM Xtra: Doctor, Doctor – We Need More Family Doctors

  Date: December 12, 2023 Reference: OCFP News. More Than Four Million Ontarians Will Be Without a Family Doctor by 2026. Nov 7, 2023 Guest Skeptic: Dr. Mahaleh Mekalai Kumanan attended Dalhousie University for her undergraduate studies, Master of Health Administration degree and medical school...

  
• 12.16.2023

  SGEM#423: Where is the Love? Microaggression in the Emergency Department

  Reference: Punches et al. Patient Perceptions of Microaggressions and Discrimination Towards Patients During Emergency Department Care. AEM Dec 2023 Date: December 14, 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also an...

  
• 12.09.2023

  SGEM Xtra: Open Label Placebo

  Date: November 20, 2023 Reference: Jones et al. Time to reflect on open-label placebos and their value for clinical practice. PAIN October 2023 Guest Skeptic: Dr. Caitlin Jones is a Postdoctoral Research Associate at Sydney University’s institute for Musculoskeletal Health. Her research...

  
• 12.02.2023

  SGEM#422: And It was all Yellow-Nasal Discharge and Antibiotics in Pediatric Sinusitis

  Reference:  Shaikh N, et al. Identifying children likely to benefit from antibiotics for acute sinusitis: a randomized clinical trial. JAMA July 2023 Date: October 17, 2023 Guest Skeptic: Dr. Alasdair Munro is a clinical research fellow specializing in pediatric infectious disease at...

  
• 11.25.2023

  SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area?

  Date: November 22, 2023 Reference: Stopyra et al. Delayed First Medical Contact to Reperfusion Time Increases Mortality in Rural EMS Patients with STEMI. AEM November 2023. Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of...

  
• 11.12.2023

  SGEM#420: I get knocked down, but I get up again – do I have a scaphoid fracture?

  Date: November 2, 2023 Reference: Coventry et al. Which clinical features best predict occult scaphoid fractures? A systematic review of diagnostic test accuracy studies. Emerg Med J. Aug 2023 Guest Skeptic: Dr. Matt Schmitz is an Orthopaedic Surgeon who sub-specializes in adolescent sports and...

  
• 11.04.2023

  SGEM Xtra: Say What You Need to Say…but Don’t Say “Sepsis Screening”

  Reference: Roland D, Munro A. Time for paediatrics to screen out sepsis “screening.” BMJ. June 2023 Date: Sept 12, 2023 Guest Skeptic: Dr. Damian Roland is a Consultant at the University of Leicester NHS Trust and Honorary Professor for the University of...

  
• 10.28.2023

  SGEM#419: Welcome Back – To Another Episode on Back Pain

  Date: October 26, 2023 Reference: Jones et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial placebo-controlled trial. Lancet July 2023 Guest Skeptic: Dr. Sergey Motov is an Emergency Physician in the Department of Emergency Medicine, Maimonides Medical...

  
• 10.21.2023

  SGEM#418: I Ain’t Missing You – Spinal Epidural Abscess

  Date: October 20, 2023 Reference: Cai et al. Implementation of a Clinical Management Tool for Spinal Epidural Abscess Early Diagnosis. AEM October 2023. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: You are in your group meeting and have...

  
• 10.14.2023

  SGEM #417: Everybody’s Changing…the Reference Ranges for Pediatric Vital Signs

  Reference: Brennan L et al. Time to change the reference ranges of children’s physiological observations in emergency care? A prospective study. J Paediatr Child Health. March 2023 Date: July 12th, 2023 Guest Skeptic: Dr. Vicki Currie is a paediatric emergency medicine registrar...

  
• 09.30.2023

  SGEM#416: She’s Always A Woman, Query PE?

  Date: September 28, 2023 Reference: Jarman et al. Sex Differences in Guideline-Consistent Diagnostic Testing for Acute Pulmonary Embolism Among Adult Emergency Department Patients Aged 18-49. AEM September 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also the...

  
• 09.09.2023

  SGEM#415: Buckle Down for some Ultrasound to Diagnosis Distal Forearm Fractures

  Reference: Snelling et al. Ultrasonography or radiography for suspected pediatric distal forearm fractures. New England Journal of Medicine June 2023 Date: July 19, 2023 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anesthesia, and...

  
• 09.02.2023

  SGEM#414: The SQuID Protocol

  Date: August 30, 2023 Reference: Griffey et al. The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics. AEM August 2023 Guest Skeptic: Dr. Suchismita Datta. She is an Assistant Professor and Director of Research in the Department of Emergency Medicine at...

  
• 08.26.2023

  SGEM Xtra: Skeptico Evidentium – SGEM Season#10 Book

  Date: August 20th, 2023 Reference: Milne WK, Challen K, Young T. Skeptics’ Guide to Emergency Medicine Season #10 Book Guest Host: Dr. Kirsty Challen is a Consultant in Emergency Medicine and Emergency Medicine Research Lead at Lancashire Teaching Hospitals Trust (North West England). She...

  
• 08.19.2023

  SGEM#413: But Even You Cannot Avoid…Pressure – Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage

  Date: August 14, 2023 Reference: Ma et. al. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial. Lancet 2023 Guest Skeptic: Dr. Mike Pallaci is a Professor of Emergency...

  
• 08.05.2023

  SGEM#412: I Can’t Choose…from all the Head Injury Prediction Rules

  Reference: Easter JS et al. Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study. Annals of Emergency Medicine 2014. Date: July 10, 2023 Guest Skeptic: Dr. Joe Mullally is a paediatric trainee in the...

  
• 07.29.2023

  SGEM#411: Heads Won’t Roll – Prehospital Cervical Spine Immobilization

  Date: July 21, 2023 Reference: McDonald et al. Patterns of change in prehospital spinal motion restriction: a retrospective database review. AEM July 2023 Guest Skeptic: Dr. Chris Bond is an emergency medicine physician and assistant Professor at the University of Calgary. He is also...

  
• 07.22.2023

  SGEM#410: Do You See What I See? Video Laryngoscope for Intubation

  Date: July 21, 2023 Reference: Prekker et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. NEJM 2023 Guest Skeptic: Dr. Jeff Jarvis is the Chief Medical Officer and System Medical Director for the Metropolitan Area EMS Authority in Fort Worth,...

  
• 07.15.2023

  SGEM Xtra: Hurts so Good…but does it Have to? A Pain Management Standard for Children

  Date: 15 June 2023 Guest Skeptic: Dr. Samina Ali is a pediatric emergency medicine physician, clinician scientist, and Professor of Pediatrics and Emergency Medicine at the University of Alberta in Edmonton. Her research focuses on improving assessment and treatment of pain...

  
• 07.08.2023

  SGEM#409: Same as it Ever Was – Tamiflu for Influenza?

  Date: July 6, 2023 Reference: Hanula R et al. Evaluation of oseltamivir used to prevent hospitalization in outpatients with influenza: a systematic review and meta-analysis. JAMA Int Med 2023. Guest Skeptic: Dr. Anand Swaminathan is an Assistant Professor of Emergency Medicine at Staten Island University Hospital....

  
• 07.02.2023

  SGEM#408: Hey, I, Oh I’m Still Alive – Is it due to TXA?

  Date: July 1, 2023 Reference: PATCH-Trauma Investigators and ANZICS Clinical Trial Group. Prehospital Tranexamic Acid for Severe Trauma. NEJM 2023. Guest Skeptic: Dr. Salim Rezaie is a community emergency physician in San Antonio, TX.  He is the Creator and founder of REBEL EM, a...

  
• 06.24.2023

  SGEM#407: Here We Go Test Strips for Fentanyl

  Date: June 16, 2023 Reference: Reed et al. Pilot Testing Fentanyl Test Strip Distribution in an Emergency Department Setting: Experiences, Lessons Learned, and Suggestions from Staff. AEM June 2023 Guest Skeptic: Dr. Lauren Westafer is an Assistant Professor in the Department of Emergency Medicine at...

  
• 06.17.2023

  SGEM#406: Homeward Bound…after a dose of Intranasal Fentanyl for Sickle Cell Vaso-occlusive Pain

  Date: June 15, 2023 Reference: Rees CA et al. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. American Journal of Hematology Jan 2023 Guest Skeptic: Dr. Amy...

  
• 06.10.2023

  SGEM Xtra: I Wish that I Had Jesse’s Book

  Date: June 6th, 2023 Reference: Pines, Raja, Bellollo and Carpenter. Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules 3rd Edition Guest Skeptic: Dr. Jesse Pines is the Chief Clinical Innovation at US Acute Care Solutions and a Clinical Professor and George Washington University and...

  
• 06.04.2023

  SGEM#405: We’re Off To Never-Never Land – But Should We Use Etomidate for the Rapid Sequence Intubation?

  Date: June3, 2023 Reference: Kotani et al. Etomidate as an induction agent for endotracheal intubation in critically ill patients: A meta-analysis of randomized trials. Journal of Critical Care April 2023 Guest Skeptic: Dr. Amber Gombash is an emergency physician in Concord, NC. Case: You have...

  
• 05.20.2023

  SGEM #404: Sitting on the Dock of the Bay-esian Interpretation of Therapeutic Hypothermia for Pediatric Cardiac Arrest

  Date: May 10, 2023 Reference: Harhay MO, et al. A bayesian interpretation of a pediatric cardiac arrest trial (THAPCA-OH). NEJM Evidence. 2023. Guest Skeptic: Dr. Kat Priddis is a paediatric emergency medicine consultant and trauma director at Watford General Hospital. She is...

  
• 05.13.2023

  SGEM#403: Unos, Dos, Tres – Vertigo: The GRACE-3 Guidelines

  Date: April 12, 2023 Reference: Edlow et al.Guidelines for Reasonable and appropriate care in the emergency department 3 (GRACE-3): Acute dizziness and vertigo in the emergency department. AEM May 2023 Guest Skeptic: Dr. Jonathon Edlow has practiced emergency medicine for nearly 40 years...

  
• 05.06.2023

  SGEM Xtra: I’m So Excited – But Don’t Call It Excited Delirium

  Date: April 25, 2023 Reference: Walsh et al. Revisiting “Excited Delirium”: Does the Diagnosis Reflect and Promote Racial Bias? WJEM 2023 Guest Skeptic: Dr. Brooks Walsh is a former paramedic, and is currently an emergency physician in the Bridgeport Hospital, Yale-New Haven Health in...

  
• 04.29.2023

  SGEM#402: Call Me – On the Telemental Health Line

  Date: April 26, 2023 Reference: Han et al. The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care. AEM April 2023 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. He is also...

  
• 04.22.2023

  SGEM #401: Hey Ho! High Flow vs Standard Oxygen Therapy for Hospitalized Children with Respiratory Failure

  Date: April 20, 2023 Reference:  Franklin D, et al. Effect of early high-flow nasal oxygen vs standard oxygen therapy on length of hospital stay in hospitalized children with acute hypoxemic respiratory failure: the PARIS-2 randomized clinical trial. JAMA 2023 Guest Skeptic: Dr....

  
• 04.15.2023

  SGEM#400: A little Bit of Heart and Sports Related Sudden Cardiac Arrest in Women

  Date: April 12, 2023 Reference: Weizmann et al. Incidence of Cardiac Arrest During Sports Among Women in the European Union. JACC November 2022 Guest Skeptic: Dr. Susanne (Susy) DeMeester is an Emergency Physician practicing at St Charles Medical Center in Bend, Oregon. She has been...

  
• 04.08.2023

  SGEM Xtra: This is My Life – Centralization of Rural Emergency Healthcare

  Date: April 4th, 2023 Reference: Vaughan and Browne. Reconfiguring emergency and acute services: time to pause and reflect. BMJ Qual Saf. 2023 Apr Guest Skeptics: Dr. Louella Vaugh is an internist practising as a hospitalist physician at an academic centre in London, UK...

  
• 04.01.2023

  SGEM#399: I’m So Tired – Emergency Medicine and Fatigue

  Date: March 28, 2023 Reference: Fowler et al. Objective assessment of sleep and fatigue risk in emergency medicine physicians. AEM March 2023 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: You arrive at 7am...

  
• 03.25.2023

  SGEM#398: Another Ab Gets BUSED – POCUS in the ED for Biliary Disease

  Date: March 22, 2023 Reference: Hilsden et al. Point of care biliary ultrasound in the emergency department (BUSED) predicts final surgical management decisions. Trauma Surg Acute Care Open 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency...