Foamcast - Emergency Medicine Core Content

The FOAM realm has teamed with interest in a randomized trial in the ICU by Semler et al, the FELLOW trial. This week we cover some aspects of this trial, such as statistical power, highlighted in some of the following Free Open Access Medical Education (FOAM) posts   EMCrit The Bottom Line EM Literature of Note St. Emlyn's REBEL EM Then, we delve into core content on epistaxis and sinusitis using Rosenalli (Tintinalli (7e) Chapter 239, “Epistaxis, Nasal Fractures, and Rhinosinusitis.” Rosen’s  (8e) Chapter 75, “Upper Respiratory Infection.", "Otolaryngology") as a guide. Thanks for listening, Jeremy Faust and Lauren Westafer

We cover a trick of the trade from Dr. Brian Lin, posted on the Academic Life in Emergency Medicine (ALiEM site) on hemostasis in finger tip avulsions. Dr. Lin also has his own excellent FOAM site on all things laceration - LacerationRepair.com. We also cover FOAM on dogma of wound care from Dr. Ken Milne's The Skeptic's Guide to Emergency Medicine, Episode #63   Then we cover laceration and wound care core content pearls using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine Review).

This miniature FOAMcast episode brings you pearls the American College of Emergency Physicians annual meeting, ACEP15 in Boston. We summarize some popular highlights from Day 3 including foodborne illness, wound management, and tips for giving presentations.

This miniature FOAMcast episode brings you pearls the American College of Emergency Physicians annual meeting, ACEP15 in Boston. We summarize some popular highlights from Day 2 including ECMO, trauma myths, and renal colic.

This miniature FOAMcast episode brings you pearls the American College of Emergency Physicians annual meeting, ACEP15 in Boston. We summarize some popular highlights from Day 1 including Jerry Hoffman and Rick Bukata's literature review and a talk from Dr. Jeff Kline on pulmonary embolism.

We cover an episode of the Ultrasound Podcast, in which Drs. Matt Dawson, Mike Mallin, and Jacob Avila demonstrate how to diagnose rib and sternal fractures with bedside ultrasound.   Then we cover core content pearls using Rosen's, Tintinalli, and the EAST guidelines on rib fractures, sternal fractures, and blunt cardiac injury. Visit foamcast.org for references as well as generously donated Rosh Review questions. Thanks y'all! -Jeremy Faust and Lauren Westafer

In this tiny episode we do something a little different. Dr. Paul Young (@dogICUma) and colleagues published two papers in JAMA and NEJM, SPLIT and HEAT, respectively.   SPLIT is an RCT looking at balanced crystalloid vs 0.9% NaCl and AKI, an ever popular topic in FOAM. HEAT is an RCT of acetaminophen in ICU patients.   We'll be back with regular episodes, soon.   -Jeremy Faust and Lauren Westafer

In this episode, we cover the New York Times article, "What Comes After The Heimlich Maneuver" and Dr. Seth Trueger's take on this article, "Bad Idea Jeans." The take home message - cricothyrotomies should be done by experts and we should probably traine ourselves for these a little better. Then, we cover core content pearls on tracheostomy emergencies and a quick summary of infections in or near the trachea.  Visit foamcast.org for more as well as generously donated Rosh Review questions. Thanks y'all! -Jeremy Faust and Lauren Westafer

This tiny episode covers a blog entry from BrownCoatNation.com (University of Illinois, Chicago), who has a new series entitled “Inconceivable.” The idea is to expose medical terminology that we tend to use incorrectly. The first installment is focused on the misuse of the term "left shift," and it's the focus of this FOAMcastini. 'Left shift" refers to the presence of banded (immature) neutrophils in the blood. It does not refer to an elevated white blood cell count with a high percentage of neutrophils. An elevated white blood cell count with an abnormally high percentage of neutrophils should be called "neutrophillic leukocytosis." Only the presence of immature neutrophils in the periphery (including bands) can accurately be called a "left shift."  We will be back shortly with regular episodes, once their schedules coincide. Thanks for listening!  

In this episode, we cover the St. Emlyn's team's post on the REVERT trial, which added a new spin to the traditional (and traditionally ineffective) Valsalva maneuver for stable supraventricular tachycardia (SVT). In this post, Dr. Rick Body goes through the trial covering not only the results and also drops pearls on methodology. Then, we cover core content pearls on supraventricular tachycardia and ventricular tachycardia. Visit foamcast.org for more as well as generously donated Rosh Review questions. Thanks y'all! -Jeremy Faust and Lauren Westafer

This week we cover Dr. Ryan Radecki's post on Gestational Age Adjusted D-Dimer covering an article by Murphy et al.  Then we review the differential diagnosis and workup of hemoptysis using Rosen's Emergency Medicine and Tintinalli as a guide. We have Rosh Review questions and more available on our website, FOAMcast.org. Thanks y'all! -Jeremy Faust and Lauren Westafer  

This week we cover Dr. Rory Spiegel's post on initial non-operative management of acute appendicitis in his blog post on EMnerd reviewing a paper by Salminen et al. Then we review appendicitis and some other right lower quadrant abdominal pearls using Rosen's Emergency Medicine and Tintinalli as a guide. We have Rosh Review questions and more available on our website, FOAMcast.org. Thanks y'all! -Jeremy Faust and Lauren Westafer  

This week we cover posts from the Wessex ICS site, The Bottom Line, which is an excellent source for breakdown of recent and important trials. We cover their post on a systematic review of peripheral pressor complications (Loubani et al) and then we delve into a recent prospective trial by Cardenas-Garcia and colleagues that came up at SMACC. Then we review peripheral vasopressors using Tintinalli and Rosen's Emergency Medicine as a guide.  We have Rosh Review questions and more available on our website, FOAMcast.org. Thanks y'all! -Jeremy Faust and Lauren Westafer

ACEP released an updated clinical policy on the use of tPA for acute ischemic stroke in June 2015.  We reviewed this on a prior episode. While we are not an interview based show, we had to seize the opportunity to talk with those with more experience.  In this episode, Jeremy interviews Dr. Jerry Hoffman, a notorious tPA critic. We shall return to regular core content soon. -Jeremy Faust and Lauren Westafer

ACEP published the clinical policy on the use of tPA for acute ischemic stroke in June.  We covered the draft in January in a FOAMcastini.  Given some significant changes, we wanted to update y'all to ensure we deliver accurate information. We review the changes and then tap our tPA brain trust, Drs. Anand Swaminathan, Ken Milne, Ryan Radecki, and David Newman for expert opinion.

FOAMcast is bringing you pearls from conferences we attend including SMACC.  (and next June 13-16, we'll bring you pearls from smaccDUB in Dublin, Ireland) Today we discuss some pearls on shift work, analgesia (even without drugs), the perils of the Glasgow Coma Scale and more!

FOAMcast is bringing you pearls from conferences we attend including SMACC.  (and next June 13-16, we'll bring you pearls from smaccDUB in Dublin, Ireland) Today we discuss some pearls on pediatric fluids, impact apnea, evidence based medicine, and death.  

FOAMcast is bringing you pearls from conferences we attend including SMACC.   The overarching theme to Day 1 at SMACC?  Use your team-to check you and for feedback.  Dr. Cliff Reid reminded us to follow up our patients and outcomes and learn from it all, without letting our egos get in the way.   Dr. Simon Carley (St. Emlyn's) gave a powerful talk on learning from mistakes later in the day; you will definitely want to listen to these when they come out. We cover trauma pearls from Dr. Scott Weingart, pain pearls from Dr. Reuben Strayer, tox pearls form Dr. David Juurlin, and a bunch of sepsis goodness. 

We review this post from Dr. Scott Weingart's EMCrit podcast on Thyroid Storm. Then, we delve into core even more content pearls on the thyroid including differentiating different hyperthyroid states and mxyedema coma.  We do this using Tintinalli and Rosen's as guides.  As always, visit foamcast.org for show notes and the generously donated Rosh Review questions. Thanks y'all! -Jeremy Faust and Lauren Westafer

We review this  post from Dr. Anton Helman of Emergency Medicine Cases on Pediatric DKA.  Then, we delve into core content pearls on hyperglycemia including Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State.  We do this using Tintinalli and Rosen's as guides.  As always, visit foamcast.org for show notes and the generously donated Rosh Review questions. Thanks y'all! -Jeremy Faust and Lauren Westafer