Foamcast - Emergency Medicine Core Content

 A recent study in Academic Emergency Medicine by Hughes and colleagues, looks at the potential clinical relevance of having emergency physicians sign ECGs read "normal" by the computer software.  FOAM reviews of this article can be found here: Dr. Smith's ECG blog Emergency Medicine Literature of Note REBEL EM Then we review ischemia on ECGs, including STEMIs as well as a dive into ischemic T waves Check out FOAMcast.org for more show notes and images. Thanks for listening! Lauren Westafer and Jeremy Faust

We cover an episode of The Skeptic's Guide to Emergency Medicine that covers a validation study of the Step by Step approach to pediatric fever.  This approach to infants with a fever

We cover a post from the fantastic St. Emlyn's team which breaks down a recently published article in Annals of Emergency Medicine comparing diazepam with placebo in patients with acute low back pain.  We recommend you read the full text of the article by Friedman et al. We delve into core content on red flags in back pain and spinal epidural abscess using Rosen's Emergency Medicine and Tintinalli's Emergency Medicine Chapter 279 as a guide. visit FOAMcast.org for show notes and more information. Thanks for listening! Lauren Westafer and Jeremy Faust

  We cover Free Open Access Medical Education (FOAM) on Contrast-Induced Nephropathy (CIN).  Recent interes The American College of Radiology (ACR) Manual on Contrast Induced Nephropathy This Emergency Medicine Literature of Note post covers the AMACING  trial, which looks at intravenous fluid administration (0.9% NaCl) versus usual care in patients "at risk" for CIN undergoing contrast-enhanced CT scan.   The study found a difference of -0.1% (95% CI -2.25 to 2.06), which was below the non-inferiority margin. Prior literature shows similar results, with no clear-cut efficacy from prevention strategies for CIN. This post by Dr. Joel Topf (nephrologist @kidneyboy) on the Precious Bodily Fluids blog discusses a nephrologist's take on CIN. EM topics post on fluids in CIN. Core Content We then delve into core content on genitourinary trauma using Rosen’s Chapter 47 and Tintinalli’s Chapter265 as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer

Ultrasound is gaining popularity in assisting lumbar punctures (LPs). We review this technique as well as Free Open Access Medical Education (FOAM) from the following sites:  5 Min Sono, Sinai EM, and PEM pearls from ALiEM. We then delve into core content on meningitis, encephalitis, and antiNMDA receptor encephalitis using Rosen's Chapter 109 and Tintinalli's Chapters 117 and 174 as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer  

We cover FOAM on transvenous pacing from Ultrasound Podcast, Dr. Jason Nomura, and Dr. Al Sachetti     Then, we delve into basics on bradycardias using Rosen's Emergency Medicine and Tintinalli's as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer

The Surviving Sepsis Campaign Guidelines were updated, reflecting some changes carried forward from Sepsis 3.0 that was released in 2016. In this podcast we go over some of the updates, many of the recommendations that stayed the same. As a bonus we cover a new study on validation of qSOFA. Show notes at FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

A lot of good literature came out in 2016 so we wanted to mention a couple of our favorite articles of the year. Sepsis 3.0 Singer M, Deutschman CS, Seymour CW, et al: The Sepsis Definitions Task Force The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). The quick SOFA score (qSOFA) also came out in hopes it "provides simple bedside criteria to identify adult patients with suspected infection who are likely to have poor outcomes."  It is not part of the sepsis definition  Back Up Head Elevated Intubation Khandelwal et al. Head-elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Anesthesia and Analgesia. Apr 2016. Ketorolac Dose Motov, S, Yasavolian, M, Likourezos, A, et al. Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department. .Ann Emerg Med. 2016 Dec 16. Out of Hospital Cardiac Arrest Prognostication Jabre et al. Early Identification of Patie

We review a trick of the trade from Academic Life in Emergency medicine for temporomandibular joint (TMJ)  dislocation, the extra-oral reduction as well as other methods of TMJ reduction. We delve into core content on dental injuries including fractures, avulsion, luxations, pulpitis and more using Rosen’s Emergency Medicine (8th edition) Chapter 70 "Oral Emergencies" and Tintinalli’s Emergency Medicine (8th edition) Chapter 245 "Oral and Dental Emergencies" as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer

We review a podcast from Dr. Tim Horeczko's Pediatric Emergency Playbook on elbow injuries including identifying normal ossification centers (CRITOE), radial head subluxation, and supracondylar fractures. Then, we delve into core content on other elbow adjacent injuries including elbow dislocations, humerus fractures, and olecranon bursitis using Rosen’s Emergency Medicine (8th edition) Chapter  and Tintinalli’s Emergency Medicine (8th edition) Chapter  as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer

We review a talk by Dr. Sara Gray from SMACC (Social Media and Critical Care) conference in June 2016, Resuscitative hysterotomy, which is the new name for perimortem c-section [1]. In this talk she challenges the "4 minute" rule: if resuscitative efforts following maternal circulatory arrest are unsuccessful, cesarean delivery should be commenced at 4 minutes and completed by 5 minutes to optimize fetal outcome.  Then we delve into core content on pregnancy emergencies using Rosen’s Emergency Medicine (8th edition) Chapter 98and Tintinalli’s Emergency Medicine (8th edition) Chapter 178 as a guide, discussing nausea and vomiting, hyperemesis gravidarum, bacteriuria, and vaginal bleeding in the first trimester. Thanks for listening! Jeremy Faust and Lauren Westafer

The PESIT study in the New England Journal of Medicine stirred up controversy in the FOAM world earlier in October 2016.  In this episode we cover the following posts on this article on pulmonary embolism in syncope: Dr. Rory Spiegel of EMnerd  Dr. Ryan Radecki of EM Literature of Note St. Emlyn's Rebel EM  Then, We delve into core content on syncope usingRosen's Emergency Medicine (8th edition) and Tintinalli's Emergency Medicine (8th edition) Chapter 52   Thanks for listening! -Jeremy Faust and Lauren Westafer

We are bringing y'all pearls from ACEP 2016 in Las Vegas. Today we cover Bell's Palsy (are you sure it's not a stroke?), burn dogma, and some hot abstracts of the year. Thanks for listening! Jeremy Faust and Lauren Westafer

We are at ACEP 2016 summarizing the hottest pearls Today we cover placebos in the ED for back pain, nausea, and upper respiratory tract infections as well as atrial fibrillation management controversies and vaccine side effects. Thanks for listening! Jeremy Faust and Lauren Westafer

We bring you highlights from ACEP2016 in Las Vegas. Today we focus on the care of the transgender patient and some pearls on caring appropriately for our diverse patients. We also cover active shooters and lawsuit pearls   Thanks for listening! Jeremy Faust and Lauren Westafer

We cover an incredible ophthalmology resource, OphthoBook.com, by Dr. Tim Roots.  This resource has a free book and excellent free video lectures.  Specifically, we detail a hilarious video on eye exam tricks, especially targeting individuals who "can't see." We previously reviewed eye trauma in this podcast. In this episode, we review ophthalmology basics using Tintinalli’s Emergency Medicine (8e), Chapter 241 Visit FOAMcast.org for more and Rosh Review questions. Thanks for listening!  Jeremy Faust + Lauren Westafer

The Free Open Access Medical Education (FOAM)  We cover a post from Dr. Josh Farkas on PULMcrit on lithium toxicity. The key message from the post is: a single serum lithium level doesn't necessitate dialysis, despite a recommendation from the EXTRIP working group  to initiate dialysis in patients with a lithium level > 5 mEq/L [1].  Dr. Farkas advocates for aggressive management in asymptomatic patients with chronic lithium toxicity and patients without impaired renal function. Core Content We review rhabdomyolysis using Rosen's Emergency Medicine (8e)  Chapter 160 and Tintinalli's Emergency Medicine (8e), Chapter 181.   Show notes at FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

We review a FOAM post by Dr. Matthew MacPartlin on Rollcage Medic on flying after a pneumothorax. Then we delve into a core content review of altitude sickness, high altitude pulmonary edema, high altitude cerebral edema, and altitude related problems using Tintinalli and Rosen's Emergency Medicine as a guide. Thanks for listening! -Jeremy Faust & Lauren Westafer

We cover several excellent post on rashes, including: Paucis Verbis Approach to Rashes - ALiEM Emergent Diagnosis of the Unknown Rash from EMJ What's That Rash? - EMdocs Next, we dive into core content on platelet problems including problems caused by drugs, immune thrombocytopenic purpura (ITP/idiopathic thrombocytopenic purpura) and thrombotic thrombocytopenic purpura (TTP) using Tintinalli Chapter 233 (8th ed) and Rosen's Chapter 122 (7th ed) as a guide.   Thanks for listening! Jeremy Faust and Lauren Westafer

We cover ultrasound guided pericardiocentesis using the posts from EMin5, CoreEM, and the Ultrasound Podcast. Then, we delve into core content on the pericardium using Rosen’s (8th ed) Chapter 82 and Tintinalli (8th ed) Chapter 55 covering pericardial effusions, pericarditis, and myocarditis.   Thanks for listening! Jeremy Faust & Lauren Westafer