The Skeptics' Guide to EM

APRIL 1, 2025

Date: April 1, 2025 This is another SGEM Xtra. I was asked to give a public lecture for the Gateway Centre of Excellence in Rural Health. The topic was the zombie idea that emergency department crowding is due to non-urgent patients.You can click on this LINK and get a PDF copy of my slides. The YouTube video of the presentation with the Q&A session featuring rural physician Dr.

ED 278

ED Emergency Department 278

The Skeptics' Guide to EM

MARCH 8, 2025

Reference: Pessano S, et al. Positioning for lumbar puncture in newborn infants. Cochrane Database Syst Rev. December 2023 Date: February 7, 2025 Dr. Lauren Rosenfeld Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. She is also a new podcast host for Emergency Medicine Residents Association (EMRA) Cast Series.

OR 177

OR ALS ED Emergency Department 177

The Skeptics' Guide to EM

MARCH 1, 2025

Reference: Bannelier et al. Failure rate of D-dimer testing in patients with high clinical probability of pulmonary embolism: Ancillary analysis of three European studies. AEM Feb 2025 Date: February 27, 2025 Guest Skeptic:Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School Baystate.

Allergic Reaction 188

Allergic Reaction ALS ED Emergency Department 188

The Skeptics' Guide to EM

FEBRUARY 22, 2025

Reference: Agnello et al. Monocyte distribution width (MDW) as a screening tool for early detecting sepsis: a systematic review and meta-analysis. Clinical Chemistry and Laboratory Medicine 2022; 60(5):786-792 Clin Chem Lab Med. 2022 Date: February 21, 2025 Guest Skeptic: Dr. Aaron Skolnik is an Assistant Professor of Emergency Medicine at the Mayo Clinic Alix School of Medicine and Vice Chair of Critical Care Medicine at Mayo Clinic Arizona.

Critical Care 151

Critical Care ICU ALS ED 151

The Skeptics' Guide to EM

DECEMBER 28, 2024

Date: December 26, 2024 Reference: Steinhauser S et al. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. AEM December 2024 Guest Skeptic:Dr. Suchismita Datta. She is anAssistant Professor and Director of Research in theDepartment of Emergency Medicine at the NYU Grossman Long Island Hospital Campus.

Emergency Department 223

Emergency Department Overdose ED ALS 223

The Skeptics' Guide to EM

DECEMBER 21, 2024

Date: December 15, 2024 Guest Skeptics: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Today, were sleighing through the holiday season with a special episode filled with statistical cheer, a dash of skepticism, and a hint of eggnog-flavoured nerdiness. This is an SGEM Xtra like the one we did on What I Learned from Top Gun. Its fun to mix it up and not do a structured critical appraisal of a recent publication and have a more philosophical chat.

OR 319

OR 319

The Skeptics' Guide to EM

NOVEMBER 30, 2024

Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program.

Epinephrine 248

Epinephrine OR CPR Paramedic 248

The Skeptics' Guide to EM

NOVEMBER 16, 2024

Date: October 28, 2024 Reference: Verma et al. Clinical evaluation of a machine learning–based early warning system for patient deterioration. CMAJ September 2024 Guest Skeptic: Michael Page is currently the Director of Artificial Intelligence (AI) Commercialization at Unity Health Toronto. He leads an AI team intending to improve patient outcomes and healthcare system efficiency.

ICU 274

ICU Emergency Department ALS ED 274

The Skeptics' Guide to EM

NOVEMBER 9, 2024

Date: October 28, 2024 Reference: Woelfle T et al. Benchmarking Human–AI collaboration for common evidence appraisal tools. J Clin Epi Sept 2024. Guest Skeptic: Dr. Laura Walker is an Associate Professor of Emergency Medicine and the vice chair for digital emergency medicine at the Mayo Clinic. In addition to finding ways to use technology in emergency department (ED) care, she is interested in how health systems work and how patients move through the healthcare system.

Emergency Department 145

Emergency Department ED ALS OR 145

The Skeptics' Guide to EM

NOVEMBER 2, 2024

Date: October 29, 2024 Reference: Galili et al. Low dose ketamine as an adjunct to morphine: a randomized controlled trial among patients with and without current opioid use. AEM Oct 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 and Program Director of the EM residency program at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County.

Emergency Department 297

Emergency Department ED ALS EMS 297

The Skeptics' Guide to EM

OCTOBER 19, 2024

Date: October 7, 2024 Reference: Nguyen et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. Guest Skeptic: Dr. Brendan Freeman is an emergency medicine physician, assistant professor of emergency medicine, and medical education fellow at Staten Island University Hospital.

OR 247

OR Emergency Department ED ALS 247

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

Date: September 18, 2024 Reference: Dillon et al. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Network Open. August 20, 2024 Guest Skeptic: Dr. Chris Root is an emergency medicine and emergency medicine service (EMS) physician at the University of New Mexico, Albuquerque. Before attending medical school, he was a New York City Paramedic.

Naloxone 259

Naloxone NARCAN Overdose CPR 259

The Skeptics' Guide to EM

SEPTEMBER 14, 2024

Date: September 12, 2024 Reference: Anderson et al. Full dose challenge of moderate, severe and unknown beta-lactam allergies in the emergency department. AEM August 2024. Guest Skeptic: Dr. Kirsty Challen is a Consultant in Emergency Medicine at Lancashire Teaching Hospitals. Case: It’s another day, another dollar in the emergency department (ED). The next patient is a 63-year-old woman with a cough and fever.

ICU 140

ICU Emergency Department ALS ED 140

The Skeptics' Guide to EM

AUGUST 31, 2024

Date: August 30, 2024 Guest Skeptic: Dr. Mel Herbert is a famous Emergency Medicine Physician, award-winning educator, entrepreneur and philanthropist. Mel founded both EM:RAP which creates and distributes Emergency Medicine education in over 160 countries. He also started a non-profit company called EM:RAP GO. This is an SGEM Xtra to end Season#12.

OR 315

OR 315

The Skeptics' Guide to EM

AUGUST 24, 2024

Date: August 19, 2024 Reference: Partyka et al. Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management: The SABRE Randomized Clinical Trial. JAMA Surg 2024 Guest Skeptic: Dr. Sean Baldwin is an Emergency Physician practising in Sydney, Australia in both a large tertiary emergency department and a small regional emergency department. Interests include information systems and digital health, research and education.

Emergency Department 133

Emergency Department ALS OR ED 133

The Skeptics' Guide to EM

AUGUST 17, 2024

Date: August 13, 2024 Guest Skeptics: We have two guest skeptics for this SGEM Xtra episode. Dr. Palma Dr. Francisco Campillo Palma is an Emergency Medicine doctor. He works in prehospital (EMS and HEMS), and at Morales Meseguer Hospital in public medical service in Murcia, Spain. Franciso has postgraduate Master's degrees in emergencies and urgent care, clinical ultrasound, and emergency and disaster management, from the University of Elche, the University of Madrid, and the University of Ovied

EMS 257

EMS OR 257

The Skeptics' Guide to EM

JULY 27, 2024

Reference: Knack et al. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med 2024 Date: July 25, 2024 Guest Skeptic: Dr. Justin Morgenstern is an emergency physician and the creator of the #FOAMed project called www.First10EM.com Case: Your hospital is running Morbidity and Mortality (M&M) rounds after a few recent cases in which the diagnosis of sepsis was identified late, and antibiotics were delayed.

ICU 245

ICU ALS Ambulance OR 245

The Skeptics' Guide to EM

JULY 6, 2024

Reference: Tjan et al. Conflict in emergency medicine: A systematic review. AEM June 2024 Date: July 5, 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School – Baystate. She co-founded FOAMcast and is a pulmonary embolism and implementation science researcher.

ED 239

ED ALS Emergency Department OR 239

The Skeptics' Guide to EM

JUNE 29, 2024

Date: June 29, 2024 Reference: Herbert L. Fred M.D. (1998) Old-Fashioned Doctors, Hospital Practice. This is an SGEM Xtra episode. I was honoured to be invited by Dr. Fernada Bellolio to the Mayo Clinic and present to the Department of Emergency Medicine. They were kind enough to allow me to speak about any topic. I decided to talk about an article Dr.

228

228

The Skeptics' Guide to EM

JUNE 15, 2024

Reference: Jansen et al. Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial. JAMA. 2023 Date: June 10, 2024 Guest Skeptic: Dr. Rob Leeper is an intensivist, trauma surgeon, and general surgeon at Western University where he also serves as the director of the Royal College Surgical Foundations program.

Life Support 296

Life Support Emergency Department ALS 296

The Skeptics' Guide to EM

JUNE 8, 2024

Reference: Kruse et al. Systematic Review, Quality Assessment, and Synthesis of Guidelines for Emergency Department Care of Transgender and Gender-diverse People Recommendations for Immediate Action to Improve Care. WJEM December 2023 Date: May 30, 2024 Guest Skeptic: Dr. Kay Dingwell is a rural emergency physician working in Prince County, PEI with a special interest in gender-affirming care and improving the care of trans and gender-diverse patients.

Emergency Department 358

Emergency Department ED ALS Paramedic 358

The Skeptics' Guide to EM

JUNE 1, 2024

Reference: Tavender E, et al. Triage tools for detecting cervical spine injury in paediatric trauma patients. Cochrane Database Syst Rev. 2024 Date: May 29, 2024 Guest Skeptic: Dr. Caleb Ward is a pediatric emergency medicine attending and Associate Professor of Pediatrics and Emergency Medicine at Children’s National Hospital and The George Washington School of Medicine and Health Sciences in Washington, DC.

Emergency Medical Services 217

Emergency Medical Services Emergency Department ALS EMS 217

The Skeptics' Guide to EM

MAY 25, 2024

Reference: Borgundvaag et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. AEM May 2024 Date: May 22, 2024 Dr. Bjug Borgundvaag Guest Skeptic: Dr. Bjug Borgundvaag is the Founding Director of the Schwartz/Reisman Emergency Medicine Institute (SREMI), at Sinai Health System.

ED 251

ED Emergency Department ICU ALS 251

The Skeptics' Guide to EM

MAY 18, 2024

Date: May 13, 2024 Guest Skeptics: Dr. Rebecca Szabo is an obstetrician/gynecologist and medical educator specializing in simulation from Melbourne, Australia working at The Royal Women’s Hospital and The University of Melbourne. This is her first time as a guest skeptic on the SGEM, she has created FOAMed content through various media, including the MedEd Stuff N Nonsense Podcast.

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The Skeptics' Guide to EM

MAY 11, 2024

Reference: Jain A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. Br J Surg. March 2023 Date: May 7, 2024 Guest Skeptic: Dr. Brian Lee is a pediatric emergency medicine attending at the Children’s Hospital of Philadelphia and Assistant Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

ALS 159

ALS Emergency Department ED OR 159

The Skeptics' Guide to EM

APRIL 27, 2024

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.

ICU 230

ICU Defibrillator CPR ALS 230

The Skeptics' Guide to EM

APRIL 20, 2024

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 […] The post SGEM#437: Don’t Be Fooled by the Meds I Got, I Still Need an ESP Block – For My Rib Fractures first appeared o

Emergency Department 214

Emergency Department Overdose ALS ED 214

The Skeptics' Guide to EM

APRIL 13, 2024

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 […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guid

ALS 342

ALS Emergency Department ED OR 342

The Skeptics' Guide to EM

MARCH 23, 2024

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 […] The post SGEM#433: Breathe – Simple Aspiration vs.

ALS 151

ALS OR 151

The Skeptics' Guide to EM

MARCH 16, 2024

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 […] The post SGEM Xtra: The Matrix – Social Media for Knowledge Translation first appeared on The Skeptics Guide to Emergency Medicine.

OR 149

OR 149

The Skeptics' Guide to EM

MARCH 9, 2024

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 […] The post SGEM Xtra: A Philosophy of Emergency Medicine first appeared on The Skeptics Guide to Emergency Medicine.

EMS 209

EMS OR 209

The Skeptics' Guide to EM

FEBRUARY 11, 2024

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. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Sy

ED 326

ED Emergency Department ALS OR 326

The Skeptics' Guide to EM

FEBRUARY 3, 2024

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 and George Washington University. She is also the director of the Pediatric Otolaryngology […] The post SGEM #429: It’s CT Angio, Hi.

ALS 170

ALS Emergency Department ED OR 170

The Skeptics' Guide to EM

JANUARY 27, 2024

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 at McMaster University and Wright State University who works as an emergency physician […] The post SGEM#428: Don’t Worry, Be Happy – The Safety of Nitroglycerin Administration in R

ALS 313

ALS Paramedic EMS OR 313

The Skeptics' Guide to EM

JANUARY 20, 2024

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, DC and Assistant Professor of Pediatrics and Emergency Medicine at George Washington University […] The post SGEM #427: I Want a Treatment with a Short Course…for Pediatric Urinary Tract Infections first

Emergency Department 186

Emergency Department ALS ICU OR 186

The Skeptics' Guide to EM

JANUARY 13, 2024

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 in the Department of Emergency Medicine at the University of New Mexico Health […] The post SGEM#426: All the Small Things – Small Bag Ventilation Masks in Out of Hospital Cardiac Arrest first appeared on The Skeptics Guide to Emergency Me

Defibrillator 272

Defibrillator CPR First Responder Epinephrine 272

The Skeptics' Guide to EM

JANUARY 6, 2024

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 in Washington, DC. Her research focuses on prehospital care of children with anaphylaxis. […] The post SGEM #425: Are You Ready for This?

Emergency Department 339

Emergency Department Emergency Medical Services ALS ED 339