The Skeptics' Guide to Emergency Medicine (SGEM) is an educational podcast dedicated to promoting evidence-based practices in emergency medicine. Hosted by Dr. Ken Milne, the podcast critically appraises recent research and clinical guidelines, aiming to bridge the gap between current evidence and clinical practice.
Disaster medicine becomes less abstract when surge capacity, triage, evacuation and incident command are taught in plain language. Bite-sized learning helps clinicians and learners, with children and families kept visible in preparedness planning.
Selected stable adults with mild to moderate DKA may not need automatic intravenous insulin when a validated subcutaneous pathway and monitoring exist. The safety check is severity, mental state, haemodynamic status, pregnancy, comorbidity, potassium and local nursing capacity.
A dramatic paediatric wrist X-ray does not always predict long-term function. Choose this for children aged 4–10 years with displaced distal radius fractures, where neurovascular status, skin integrity, remodelling potential, surgical harms and family discussion shape cast-first care.
Coffee and tea data should reassure more than prescribe. Read this for the clean explanation of why observational associations do not prove dementia prevention, and for the sensible counselling line that tolerant moderate drinkers do not need to stop, but non-drinkers do not need to start.
Start here: a well-appearing febrile neonate still needs a disciplined first pass. Use urinalysis, absolute neutrophil count and procalcitonin to identify low-risk infants, then discuss selective lumbar puncture while keeping inpatient observation, culture results and clinical deterioration in view.
A quiet older patient with acute confusion, drowsiness or agitation is easy to miss when gestalt is doing the work. Open this first for bedside delirium screening with 4AT or DTS plus bCAM, selective head CT, and the reminder to look for the precipitant rather than stop at the syndrome.
The clue is that acute confusion, falls and functional decline need a workflow, not just concern. Start here for a practical read on 4AT, realistic first steps, and how geriatric ED guidelines become something teams can actually use.
In trauma, the sequence itself can reassure the team too early. The action point is to seek catastrophic bleeding first with XABCDE, optimise haemodynamics before intubation in shock, and use structured handover so transfer decisions are not weakened by omission.
For most children with uncomplicated urticaria or allergic rhinitis, cetirizine is a better default than diphenhydramine because it lasts longer and causes less sedation. The practical systems lesson is that education alone rarely changes prescribing unless stock, pathways and order sets change as well.
In acute respiratory failure, do not let a non-inferiority headline flatten the physiology. Non-invasive ventilation still leads for COPD with hypercapnic acidosis and cardiogenic pulmonary oedema, while high-flow nasal oxygen suits prolonged hypoxaemic illness or poor mask tolerance, with early review of work of breathing and gas trend.
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