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:

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

Direct download: FOAMcast_STEMI_and_its_mimics.mp3
Category:general -- posted at: 9:08am EDT

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 <3 months old is alluring as it does not necessitate a lumbar puncture.  This algorithm had a better sensitivity and negative predictive value than the Rochester criteria.   The approach did miss some infants with a serious bacterial infection and these tended to be those between 21 and 28 days old and those with fever onset <2 hours prior to arrival. 

We cover Chapter 116 in Tintinalli's Emergency Medicine (8th ed) and Rosen's on pediatric fever.

Visit FOAMcast.org for more information and thanks for listening!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Step_by_Step_and_pediatric_fevers.mp3
Category:general -- posted at: 8:40am EDT

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

Direct download: FOAMcast_benzos_for_back_pain_.mp3
Category:general -- posted at: 3:02pm EDT

 

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

Direct download: Episode_65.mp3
Category:general -- posted at: 8:19pm EDT

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 SonoSinai 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

 

Direct download: FOAMcast_lumbar_punctures_.mp3
Category:general -- posted at: 5:14pm EDT

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

Direct download: Foamcast_transvenous_pacers_and_bradycardia.mp3
Category:general -- posted at: 5:02pm EDT

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

Direct download: Foamcast_2017_sepsis_update.mp3
Category:general -- posted at: 3:06pm EDT

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 Patients With Out-of-Hospital Cardiac Arrest With No Chance of Survival and Consideration for Organ Donation.   Intern Med. 2016 Dec 6;165(11):770-778

 

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_2016_roundup.mp3
Category:general -- posted at: 8:35pm EDT

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