Episode 47: Evidence Based Medicine from NYGH EMU Conference 2014

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 8 July 2014

⏱️ 49 minutes

🔗️ Recording | iTunes | RSS

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Summary

Dr. Walter Himmel (the 'walking encyclopedia of EM') gave a fantastic talk from North York General's Emergency Medicine Update Conference in Toronto, which have edited into a podcast with key commentary and summaries. Dr. Himmel eloquently shows us, through absolutely stunning personal cases, how evidence based medicine can be appropriately or inappropriately applied in real practice, resulting in major outcome differences for your patients. He elucidates the importance of clinical experience, patient values and ED resources in helping apply the medical literature to your practice. He reviews the essence of critical appraisal, the hierarchy of evidence and how to keep up with the emergency medicine literature. The famous NINDS thrombolysis for stroke trial is distilled down to a few key considerations and the NEJM transfusion for upper GI bleed trial from last year is dissected, analyzed and then applied to Dr. Himmel's personal cases, to help us understand exactly how to apply the literature to our daily practice. Blog post and written summary prepared by Keerat Grewal, edited by Anton Helman July 2014

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.7	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine
0:10.4	from EMC Studios in Toronto.
0:18.1	In this episode number 47, the continuation of the North York General Hospital's Emergency Update Conference highlights from 2014, we have with us the one and only Dr. Walter Himmel, who really needs no introduction. But I'll give it to you anyways. Dr. Himmel is an emergency physician at North York General Hospital and
0:39.0	Toronto East General Hospital. He's one of my biggest mentors. He's otherwise known as the
0:43.5	walking encyclopedia of emergency medicine, and he's a world-renowned speaker in emergency medicine.
0:49.7	So without further ado, here's Walter Himmel and his take on evidence-based medicine.
0:59.6	We're going on the journey back to 1976.
1:05.0	Everything I believed in my heart was absolutely wrong.
1:32.3	TPA. Is that good or evil? It's not just the evidence. It's your clinical expertise. The right evidence for the right place, for the right patient. Who in a role can you trust? Trust yourself. And here we go. This talk today is very unusual.
1:35.3	It's about philosophy, it's about history, it's about evidence-based medicine.
1:40.3	Let's go back to 1976. So put down your pens and pencils, put down your iPads and your peripherals,
1:46.6	and fasten your seatbelts, because we, you and I, we're going on their journey back to 1976.
1:52.8	Now, for some of you, you were alive in 76, you shall disappear.
2:00.3	I will bring you back.
2:02.9	Let's talk about myocard lympharchins in 1976.
2:06.4	I'm about to say you may think it's being totally bizarre, but it wasn't in 76.
2:12.4	76, here's what happened, you know, myocardine infarction.
2:15.3	First of all, you've made to the hospital for two weeks.
2:18.3	Two weeks in the hospital resting.
2:20.3	Now, you can have brain surgery and a head transplant today.
2:23.3	He ate this thing two weeks in hospital.
	...

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