FOAMcast - An Emergency Medicine Podcast (general)

In this episode, we review a consensus guideline from the American College of Emergency Physicians on the use of topical anesthetics in corneal abrasions. 

Show notes and references: FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren WEstafer

Direct download: foamcast_cornea_-_21624_12.26_PM.mp3
Category:general -- posted at: 12:27pm EDT

This episode covers emergency medicine-related recommendations from the American Heart Association's (AHA) clinical guideline on atrial fibrillation: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation Circulation. 2023

Show notes and references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: aha_afib_-_121323_11.57_AM.mp3
Category:general -- posted at: 12:29pm EDT

The AABB recently published updated recommendations for blood transfusion thresholds. This podcast reviews these recommendations and a recent study, the MINT trial, in which patients with anemia and a myocardial infarction were randomized to a restrictive strategy or liberal transfusion strategy.

Show notes / references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: faomcast_transfusion_update.mp3
Category:general -- posted at: 3:58pm EDT

This epsiode reviews the new clinical policy from the American College of Emergency Physicians (ACEP) on medication for acutely agitated patients needing parenteral sedation.

Show notes / references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: ACEP_sedation_-_12123_1.58_PM.mp3
Category:general -- posted at: 2:11pm EDT

In this episode, we review Resuscitative endovascular balloon occlusion of the aorta (REBOA), notably dissecting the recent Jansen et al trial in JAMA.

Shownotes / References:  FOAMcast.org

Thanks for listening!
Jeremy Faust & Lauren Westafer

Direct download: FOAMCAST_REBOA2.mp3
Category:general -- posted at: 3:06pm EDT

Recommendations for the use of steroids in community-acquired pneumonia have been mixed. This episode reviews a large multicenter randomized trial in the New England Journal of Medicine by Dequin et al on hydrocortisone for severe community-acquired pneumonia. 

References/show notes: FOAMcast.org


Thanks for listening!
Lauren Westafer

Direct download: foamcast_hydrocortisone.mp3
Category:general -- posted at: 11:58am EDT

In this episode we review the CLOVERS trial, a randomized trial of early (first 24 hours) restrictive versus liberal fluids. 

Show notes/references: FOAMcast.org

Thanks for listening!

Jeremy Faust + Lauren Westafer

Direct download: clovers_-_21523_8.09_AM.mp3
Category:general -- posted at: 8:11am EDT

This episode reviews guideline recommendations and literature on the management of acute, uncomplicated diverticulitis - highlighting the recommendations to only prescribe antibiotics to select patients.

References/Show Notes: FOAMcast.org

Thanks for listening!
Lauren WEstafer

Direct download: foamcast_divertic_-_2323_2.00_PM.mp3
Category:general -- posted at: 2:16pm EDT

This episode reviews a shift from the "lethal triad" in trauma to the "diamond of death," exploring the role of calcium in hemostasis and critically ill patients. We review the literature that is available on hypocalcemia and trauma patients

References/show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: diamond_of_death_calcium_trauma_foamcast.mp3
Category:general -- posted at: 10:15am EDT

This episode is a departure from the typical FOAMcast clinical content, we will be back with strictly clinical content soon.

In May 2022, I came across a fellow passenger and stranger in cardiac arrest in the airport. A small team of strangers, including an emergency medicine resident, Dr. Jason Tanner, and an emergency department technician, Angel, assembled to treat this passenger. Billy Frolick, a writer and our patient that day, shares his perspective on his case with us. 

In addition, we highlight important clinical pearls, notably the importance of continuous chest compressions and early defibrillation. For more on not doing pulse checks, see this podcast: https://foamcast.org/2022/09/04/pulse-checks-during-cardiopulmonary-resuscitation/ .

 

Direct download: foamcast___billy_-_12423_3.02_PM.mp3
Category:general -- posted at: 3:07pm EDT

This episode covers the 2022 American College of Emergency Physicians (ACEP) clinical policy on acute heart failure syndromes with a special focus on high dose nitrates

References and Show Notes: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: ACEP_HF_nitrates.mp3
Category:general -- posted at: 10:41am EDT

The American College of Cardiology released a new consensus statement endorsing several signs on the electrocardiogram (ECG) as "STEMI Equivalents." In this podcast, we review these signs.

Show notes / graphics / references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: stemi_equivalent_-_101822_1.31_PM.mp3
Category:general -- posted at: 12:52pm EDT

Since 2010, the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) have de-emphasized pulse checks - such that they recommend against routine pulse checks. Despite this recommendation, may individuals and institutions continue to perform pulse checks. This episode reviews the recommendations and the literature.

References/show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: FOAMcast_pulse_check_-_9322_3.33_PM.mp3
Category:general -- posted at: 3:36pm EDT

There is a global outbreak of human monkeypox virus cases. In this episode we provide a quick summary of monkeypox to date. Check out our two more in-depth episodes on the topic. 

References/Show notes: FOAMcast.org

Thanks for listening!

Jeremy Faust & Lauren Westafer

Direct download: monkeypox_foamcast_tldr.mp3
Category:general -- posted at: 2:09pm EDT

There is a global outbreak of human monkeypox virus cases. In this episode (the second of a 2 part series), we summarize clinical manifestations, complications, and vaccination. 

References/Show notes: FOAMcast.org

Thanks for listening!

Jeremy Faust & Lauren Westafer

Direct download: Monkeypox_FOAMCast_clinical_2.mp3
Category:general -- posted at: 1:53pm EDT

There is a global outbreak of human monkeypox virus cases. In this episode (the first of a 2 part series), we summarize some brief virology, epidemiology, and review the transmission of this virus. 

References/Show notes: FOAMcast.org

Thanks for listening!

Jeremy Faust & Lauren Westafer

Direct download: Monkeypox_FOAMCast_first.mp3
Category:general -- posted at: 1:18pm EDT

We review the Anorectal emergencies: WSES-AAST guidelines on complicated hemorrhoids that include some practice-changers

References: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: foamcast_hemorrhoids_-_72322_7.11_AM.mp3
Category:general -- posted at: 7:23am EDT

Diphenhydramine (Benadryl) and other first-generation antihistamines are commonly used, despite decades of data that there are safer and effective alternatives.  In this podcast, we review the guidelines / data behind common indications.

References at FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: diphenhydramine_-_6822_1.31_PM.mp3
Category:general -- posted at: 1:42pm EDT

In this episode we review acute urticaria and new guidelines related to the treatment of urticaria. We review additional relevant trials Palungwachira et al and Barniol et al

References/Show notes: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: urticaria_-_31122_2.28_PM.mp3
Category:general -- posted at: 2:30pm EDT

In this podcast we discuss onset of action of various intramuscular agents for chemical sedation for severely agitated patients. This includes a study by Barbic et al on ketamine, the onset of action of midazolam (and association with length of stay), and is droperidol really magic? (Cole et al

Shownotes/References: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: IM_agents_foamcast_-_12322_1.44_PM.mp3
Category:general -- posted at: 1:32pm EDT

Outpatient management of pulmonary embolism for low-risk patients has been encouraged for several years. However, little is known about pulmonary embolism diagnosed and managed exclusively in the outpatient setting. In this study, Vinson et al describe the course of patients diagnosed with PE and managed in the outpatient setting in an integrated healthcare delivery system.

Shownotes/References: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: PEPc.mp3
Category:general -- posted at: 3:03pm EDT

The diagnostic algorithm for pulmonary embolism (PE) has evolved over the past few years to include probability or risk-adjusted D-dimer. The YEARS algorithm includes an elevated D-dimer threshold for some risk groups and has been found to be safe and reduce imaging in several studies, including in pregnant patients. Now, this multicenter trial by Freund et al evaluates use of YEARS and age-adjusted D-dimer compared with an age-adjusted approach alone.

Shownotes/References: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: YEARS_update_2021.mp3
Category:general -- posted at: 10:04am EDT

A seminal single-center study in 2018 by Driver et al found a 98% first-pass success in patients undergoing endotracheal intubation in the Emergency Department. This multi-center randomized control trial examines bougie vs stylet in a wider array of settings

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: bougie_driver_2021.mp3
Category:general -- posted at: 9:41am EDT

Subsegmental pulmonary embolism (SSPE) is a controversial entity as they have uncertain clinical significance. As a result, the Chest Guidelines  and ACEP guidelines state that a very select group of patients with isolated SSPE and no deep vein thrombosis may be managed with surveillance rather than anticoagulation. In this podcast we review SSPE and a new prospective study by Le Gal and colleagues.

Show notes and references: FOAMcast.org

Thanks for listening!

Lauren Westafer

Direct download: SSPE_anticoagulation_-_12921_12.57_PM.mp3
Category:general -- posted at: 2:14pm EDT

We review the FDA briefing document from Pfizer   as well as from the CDC Advisory Council on Immunization Practices that approved the Pfizer-BioNTech COVID-19 vaccine in children ages 5-11.


References and show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: covid_pedi_vax_5-11_-_11221_7.08_PM.mp3
Category:general -- posted at: 7:12pm EDT

We previously covered the management of young febrile infants in a 2017 podcast  but now we have updated guidance from the AAP. In this podcast, we review the 2021 AAP Guidelines for the management of well-appearing febrile infants 8-60 days old, highlight practice-changing recommendations.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: aap_pedi_fever_-_101921_2.42_PM.mp3
Category:general -- posted at: 3:23pm EDT

In this episode, Jeremy discusses what we know about breakthrough infections in the delta variant era and what this may mean for COVID-19 vaccine boosters.

Jeremy's takes can be found at Inside Medicine

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: delta_breakthrough.mp3
Category:general -- posted at: 2:34pm EDT

In this episode, we discuss the current evidence (as of September 24, 2021) on COVID-19 vaccine boosters as well as the CDC recommendations and the details of the Advisory Council on Immunization Practices recommendations/vote.

Show notes/References at FOAMcast.org

Jeremy's takes can be found at Inside Medicine

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: booster_vax_covid.mp3
Category:general -- posted at: 2:06pm EDT

In this literature update podcast covering important papers of 2021, we cover Becattini et al on the assessment of right ventricular dysfunction in patients diagnosed with acute pulmonary embolism (PE). We review guidelines on PE risk stratification for severity and discuss this individual patient meta-analysis.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

 

Direct download: PE_right_ventricle_dysfunction_-_81021_3.40_PM.mp3
Category:general -- posted at: 6:43pm EDT

This is a quick literature update on practice-changing literature from 2021. Here we discuss Pappal et al in Annals of Emergency Medicine on awareness during paralysis in mechanically ventilated patients

Show notes / References: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: ED_awareness.mp3
Category:general -- posted at: 9:24am EDT

This is a quick literature update of important literature in 2021 covering take-home naloxone by Kilaru et al. In this episode, we discuss principles of harm reduction, including naloxone, as well as the study. 

Show notes, references, and resources: FOAMcast.org

Thanks for listening!

Lauren Westafer and Jeremy Faust

Direct download: take_home_naloxone.mp3
Category:general -- posted at: 7:47pm EDT

We review new clinical policy guidelines from SAEM on patients with recurrent (2 ED evaluations in 12 months) low risk (e.g. HEART score <4) chest pain.

Show notes and references: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: Foamcast_grace_chest_pain_-_7_7_21_12.11_AM.mp3
Category:general -- posted at: 8:33am EDT

In this episode, we review the data on the association between myocarditis and the mRNA COVID-19 vaccines.

Show notes / References: FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: Foamcast_vaccine_myocarditis_-_6_23_21_10.28_PM.mp3
Category:general -- posted at: 6:48am EDT

In this quick literature update, we review a recent paper by Branch et al on early 'panscan' (head to pelvis CT scan ) in patients with return of spontaneous circulation after out of hospital cardiac arrest. 

Show notes/ references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: OHCA_foamcast_panscan_-_6921_11.28_AM.mp3
Category:general -- posted at: 3:04pm EDT

In this episode we review what we know about vaccine induced thrombotic thrombocytopenia (VITT), which has been associated with the COVID-19 viral vector vaccines by AstraZeneca and Johnson & Johnson.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: VITT_-_41421_6.14_PM.mp3
Category:general -- posted at: 6:21pm EDT

In this podcast, we review Cerebral Vein Thrombosis (CVT) including clinical presentation, diagnosis, and management.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: foamcast_CVT2_-_41421_8.47_PM.mp3
Category:general -- posted at: 10:10am EDT

In this episode, we discuss ivermectin as a potential therapeutic for COVID-19 and review available randomized trials evaluating this drug.

Show notes: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_ivermectin_for_covid.mp3
Category:general -- posted at: 9:13am EDT

In this episode, we review new registry data from the ACIP meeting on pregnant people who received an mRNA COVID-19 vaccine and discuss, in general, what we know about the COVID-19 vaccines in pregnancy. 

Show notes: FOAMcast.org

Pregnancy Decision Aid

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: covid_vax_preg_update_-_3321_9.28_AM.mp3
Category:general -- posted at: 7:25pm EDT

In this episode, we review the FDA briefing document on the Janssen (Johnson & Johnson) viral vector COVID-19 vaccine.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer & Jeremy Faust

Direct download: jJ.mp3
Category:general -- posted at: 9:16am EDT

We have previously covered epistaxis on FOAMcast , including the use of tranexamic acid (TXA). Now, we cover a new, large RCT, the NoPac trial by Reuben et al, on TXA for epistaxis.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: epistaxis_nopac.mp3
Category:general -- posted at: 2:10pm EDT

There's been a lot of excitement over various drugs for COVID-19, including anti-inflammatory drugs. Colchicine, a medication long used for gout, fits that bill. In this podcast, we review 3 trials of colchicine including COLCORONA, GRECCO-19, and a study by Lopes et al

Show notes: FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: foamcast_covid_colchicine_.mp3
Category:general -- posted at: 9:28am EDT

Early studies of tocilizumab, a monoclonal antibody that binds interleukin-6 , were disappointing. However, the REMAP-CAP trial recently reported a benefit to tocilizumab in non-critically ill hospitalized patients with COVID-19. Now, from the RECOVERY trial (the trial that brought us dexamethasone), we have more good news for tocilizumab - which we cover in this podcast

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: recovery_toci_-_21321_9.45_AM.mp3
Category:general -- posted at: 9:48am EDT

As vaccinations role out, the news of SARS-CoV-2 variants with mutations to the spike protein have dominated news cycles. One unanswered question has been - do the current vaccines protect against these variants?

We tackle this issue and look at a new paper [pre-print] by Wu et al

Direct download: variant_-_12521_8.55_PM.mp3
Category:general -- posted at: 8:57pm EDT

Prior randomized trials of convalescent plasma in COVID-19 have had disappointing results. However, these trials included patients with severe illness who were many days (if not weeks) into the course of their illness. To date, it was hypothesized, but unknown, that the benefit would be in patients very early in the course of their illness. We cover an RCT by Libster et al in NEJM on convalescent plasma in older patients with mild COVID-19.

Show notes/references: FOAMcast.org


Thanks for listening!

Lauren Westafer and Jeremy Faust

Direct download: libster_convalescent_-_1721_7.39_AM.mp3
Category:general -- posted at: 7:41am EDT

In this quick literature update we review the new recommendations from the CDC for the treatment of gonococcal infections which include:

  • Higher dose ceftriaxone (500 mg IM) or 1 gm IM if ≥150 kg patient
  • No routine azithromycin
  • Preference for doxycycline for co-treatment of presumed chlamydial infection

Show notes and references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: cdc_gonorrhea_-_1321_3.26_PM.mp3
Category:general -- posted at: 10:02am EDT

For years studies have questioned whether pulse oximeters perform as well in non-White patients as in White patients. This is particularly important now as disposition decisions in patients with COVID-19 are often made based on pulse oximetry readings.

We discussed an article by Sjoding et al in NEJM 

Show notes at FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: Pulse_ox_Race.mp3
Category:general -- posted at: 1:52pm EDT

Despite multiple Phase II/III vaccine trials of >30,000 participants, pregnant patients or those who are lactating have been largely excluded. In this podcast, we cover what we know (and what we don't know thus far).

The Pfizer BNT162b2 trial data submitted for FDA Emergency Use Authorization does include information on a minuscule number of patients who were immunized and became pregnant.

The Society for Maternal and Fetal Medicine has released statements on vaccines in SARS-CoV-2.

In the United Kingdom, Public Health England has released guidance for their population on vaccination in pregnancy and breastfeeding which are rooted in the lack of data.

Shownotes: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: vaccine_pregnancy_and_breastfeeding.mp3
Category:general -- posted at: 1:54pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

Vaccines for SARS-CoV-2 have been in development for only a few months, but several have published early results from Phase III efficacy trials in press releases. In this episode, we review these vaccines and what we know about them, and what we know about  them

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: foamcast_covid_vaccine_interim_updates_.mp3
Category:general -- posted at: 10:30pm EDT

In this episode, we review cannabinoid hyperemesis syndrome and two recent randomized controlled trials on treatments

Show notes (references, graphics) at FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: foamcast_chs__.mp3
Category:general -- posted at: 7:29pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

Monoclonal antibodies have received significant attention over the past month and we previously podcasted on antibodies that target SARS-CoV-2. In this episode, we review several recent studies on a different "mab", tocilizumab,  which targets inflammation mediated by interleukin-6 that is overly ramped up. 

We review:

Stone et al  ( RCT)

Hermine et al (RCT)

Salvarani et al. (RCT)

STOP-COVID (observational)

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: FOAMcast_Covid_tocilizumab_and_covid.mp3
Category:general -- posted at: 10:30pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

Monoclonal antibodies have received significant attention over the past couple of weeks. In this episode, we review what we know, as of October 9, 2020, about monoclonal antibodies as a therapy for COVID-19. 

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: FOAMcast_Covid_antibodies.mp3
Category:general -- posted at: 10:10am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review a retrospective evaluation of COVID-19 infections in employees after a protocol that increased the use of high flow nasal cannula (Westafer et al)

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: HFNC_COVID_HCW.mp3
Category:general -- posted at: 2:59pm EDT

We spoonfeed you a new article on risk stratification of pulmonary embolism (with critical appraisal pearls!)

In this episode, we review a new trial by Barnes et al on antacids versus antacids with lidocaine for epigastric pain and dyspepsia

Show notes and references at FOAMcast.org

Thanks for listening,

Lauren Westafer and Jeremy Faust

Direct download: PE_barnes_et_al.mp3
Category:general -- posted at: 3:31pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review a new meta-analysis from the WHO REACT group of steroids in critically ill patients with COVID-19 and 3 new randomized trials of steroids in COVID-19 published in JAMA on September 2:

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: steroids_covid.mp3
Category:general -- posted at: 12:02pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review the evidence, to date, on convalescent plasma for the treatment of COVID-19. This includes 3 randomized trials, as well the US experience with >35,000 patients treated with convalescent plasma, a noncontrolled study by Joyner et al [pre-print].

Show notes (references/graphics): FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covid_convalescent_ii_-_82620_11.02_AM.mp3
Category:general -- posted at: 7:27pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review Spinner et al in JAMA 2020, an open label trial of remdesivir 5 days vs remdesivir 10 days vs 'standard of care' for the treatment of #COVID19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: remdesivir_spinner.mp3
Category:general -- posted at: 2:28pm EDT

 We review the Ascorbic Acid, Corticosteroids, and Thiamine in Septic Shock (ACTS) Trial by Moskowitz et al in JAMA

Show notes: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: ACTS_foamcast.mp3
Category:general -- posted at: 12:59pm EDT

We review the AAAAI 2020 anaphylaxis guideline (Shaker et al)

A lightening review of anaphylaxis, follow by a discussion of biphasic reaction and the role of steroids and antihistamines

Thanks for listening,

Jeremy Faust and Lauren Westsafer

Direct download: aaai_anaphylaxis.mp3
Category:general -- posted at: 3:23pm EDT

Introducing a new series of quick, spoonfed literature updates, 1 article at a time

In this episode we review a new trial by Warren et al on antacids versus antacids with lidocaine for epigastric pain and dyspepsia

Show notes and references at FOAMcast.org

Thanks for listening,

Lauren Westafer and Jeremy Faust

Direct download: antacid.mp3
Category:general -- posted at: 1:57pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review the RECOVERY trial results on hydroxychloroquine for COVID-19 [pre-print by Hornby et al]

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: recovery_hcq.mp3
Category:general -- posted at: 12:38pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We review the RECOVERY trial results on dexamethasone for COVID-19 [pre-print by Hornby et al]

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covid_dex_4.mp3
Category:general -- posted at: 7:54pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

We explore effects of sterilization and re-use on N95s and KN95s efficiency and fit

Sterilization of N95s and KN95s with Hydrogen Peroxide and Chlorine Dioxide (Cai et al)

Extended use/reuse of N95 and fit test failure (Degesys et al

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded June 19, 2020

Direct download: covid_mask.mp3
Category:general -- posted at: 3:50pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode we discuss data on when SARS-CoV-2 began being detected in US communities  (Jorden et al)

 

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded June 9, 2020

Direct download: covid_community.mp3
Category:general -- posted at: 4:32am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode we discuss some of the mental health ramifications of COVID-19 and the lockdowns:

US ED visits for mental health (Smalley et al)

Mental health of children during lockdown Xie et al

Psychological distress in US adults (McGinty et al)

Mood and violence in Chinese interns (Li et al)

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded June 9, 2020

Direct download: covid_psych_-_61020_12.25_PM.mp3
Category:general -- posted at: 12:38pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In an update to the Convalsecent plasma episode we now cover the first RCT on the topic, Li et al

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded June 4, 2020

Direct download: covid_convalescent_rct.mp3
Category:general -- posted at: 9:16am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews a study published by Mehra et al in the Lancet with concerning methods and data anomalies, leading to the possibility and likelihood of falsified data. This came to light after an open letter by Watson et al  detailing major issues. The Lancet issued a correction, which did not address many of the major issues and resulted in significant changes to Table S3 in the supplement. Concerningly, this group also authored the NEJM study on ACE-I/ARBs in COVID-19

Note: This is an evolving story

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded June 1, 2020

Direct download: covid_fabric_-_6120_6.01_PM.mp3
Category:general -- posted at: 6:08pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews a study published by Goldman et al dissecting a study on remdesivir - 5 day vs 10 day course.

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 30, 2020

Direct download: remdesi_5_v_10.mp3
Category:general -- posted at: 2:35pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews a study published by Wang et al that received incredible press coverage for touting benefits of mask wearing in one's own home....if it started prior to symptoms. This study is problematic, and we discuss why.

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 29, 2020

Direct download: covidcast_mask_at_home_-_53020_10.10_AM.mp3
Category:general -- posted at: 10:11am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews the NIAID trial, ACTT-1, on remdesivir vs placebo (Beigel et al)

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 23, 2020

Direct download: covid_remdesivir_-_52420_10.35_AM.mp3
Category:general -- posted at: 10:38am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews an article by Groß et al that demonstrates SARS-CoV-2 RNA can be found in breastmilk

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 22, 2020

Direct download: covid_breastfeeding_.mp3
Category:general -- posted at: 8:59pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19. *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode reviews an article by Peyrony et al examining the performance of symptoms, physical exam findings, and ultrasound on the probability of COVID-19.

We also go into a bit of an interlude on likelihood ratios

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 22, 2020

Direct download: covid_LR.mp3
Category:general -- posted at: 9:11am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode is a literature potpourri 

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 15, 2020

Direct download: covid_415_-_51520_6.51_AM.mp3
Category:general -- posted at: 7:03am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses Pediatric Multisystem Inflammatory Syndrome Temporally Associated with COVID-19 , including the study published in the Lancet by Riphagen et al

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 6, 2020

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 9, 2020

Direct download: ped_hyperinflamm_covid_.mp3
Category:general -- posted at: 8:08pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses convalescent plasma, specifically a recent systematic review by Rajendran et al

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 6, 2020

Direct download: convalescent_plasma_-_5920_1.43_AM.mp3
Category:general -- posted at: 1:49am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses antibody testing including

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded May 2, 2020

Direct download: covid_serology.mp3
Category:general -- posted at: 8:44am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses an article by Baldi et al on excess mortality and Out of Hospital Cardiac Arrest

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.29.20

Direct download: covid_ohca.mp3
Category:general -- posted at: 2:54pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses cutaneous manifestations of COVID-19 including "COVID toes"

And the more serious lesions

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.28.20

Direct download: covid_toes.mp3
Category:general -- posted at: 11:19pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses autopsy findings

and VTE

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.26.20

Direct download: covid_426_-_42720_9.53_AM.mp3
Category:general -- posted at: 9:58am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

This episode discusses an article by Caputo et al.   on self proning and oxygenation in COVID-19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.23.20

Direct download: covid_423_-_42420_8.20_AM.mp3
Category:general -- posted at: 1:20pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, Dr. Rory Spiegel (@EMNerd_) and I discuss the "switch" from early intubation to aggressive non-invasive modalities and our respiratory protocols including what we know about the evidence behind...

  • Early intubation recommendations
  • High flow nasal cannula in COVID-19
  • Self/awake proning

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.17.20

Direct download: Covid_4.19_resp_protocol_-_42020_8.17_PM.mp3
Category:general -- posted at: 6:53pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we discuss thrombosis and COVID-19, specifically:

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.18.20

Direct download: covid_thrombosis_.mp3
Category:general -- posted at: 9:07pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we discuss special populations including

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.17.20

Direct download: covid_disparities_.mp3
Category:general -- posted at: 6:42pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we discuss testing issues

And hydroxychloroquine updates

  • More data without a comparator from the Raoult group (only published as abstract and table)
  • Retrospective study with propensity matching (Mahévas et al)

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.14.20

Direct download: covid_4.14.mp3
Category:general -- posted at: 2:05pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we discuss outcomes from NYU

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.12.20

Direct download: covid_4.12.mp3
Category:general -- posted at: 8:22am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, Dr. Rory Spiegel (@EMNerd_) and I discuss risk stratification tools in COVID-19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.10.20

Direct download: covid_4.10.mp3
Category:general -- posted at: 6:03am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we discuss the NEJM article by Grien et al on the compassionate use of remdesivir in COVID-19 

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.10.20

Direct download: covid_remdesivir.mp3
Category:general -- posted at: 7:18pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we are joined by Dr. Rory Spiegel (EMNerd) and discuss what we are seeing in COVID-19 and various theories.

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

*Recorded 4.5.20

Direct download: Covid_4.7.mp3
Category:general -- posted at: 10:04am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check back for updates/fact check what you hear*

In this episode, we are joined by Dr. Rory Spiegel (EMNerd) and discuss the ROX index predicting failure of HFNC and any applicability to COVID-19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Recorded 4.5.20

Direct download: covid_4.5.mp3
Category:general -- posted at: 11:21pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we discuss emerging evidence for high flow nasal cannula 

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Recorded 4.3.20

Direct download: covid_4.3.mp3
Category:general -- posted at: 4:51am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we discuss the theory (there is no great evidence) of hypercoagulability in severe COVID-19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Recorded 4.2.20

Direct download: covid_4.2.mp3
Category:general -- posted at: 3:59pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we cover

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Recorded 3.31.20

Direct download: covid_3.31.mp3
Category:general -- posted at: 10:58pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

Recorded 3.30.20

In this episode, we cover

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covid_3.30.mp3
Category:general -- posted at: 10:13am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

Recorded 3.28.20

In this episode, we cover

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covid3.28.mp3
Category:general -- posted at: 4:41pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

Recorded 3.27.20

In this episode, we cover

  • Vertical transmission in pregnancy
  • High flow nasal cannula with a mask

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covidcast3.27.mp3
Category:general -- posted at: 8:10pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

Recorded 3.25.20

In this episode, we cover

  • Incubation period
  • Disease timeline
  • Viral shedding
  • Re-infection

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covidcast3.25.mp3
Category:general -- posted at: 12:34pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

Recorded 3.23.20

In this episode, we cover

  • Anosmia / dysgeusia
  • Gastrointestinal symptoms
  • Policy updates

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: 3.23_covid.mp3
Category:general -- posted at: 5:38am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we cover

  • Transmission of SARS-CoV-2 (including stability on surfaces / aerosols)
  • Cloth masks - do they work?
  • UV light decontamination

Recorded 3.22.20

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: covid3.22.mp3
Category:general -- posted at: 5:36am EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we cover

  • High flow nasal cannula in COVID-19
  • Cytokine storm
  • Asymptomatic transmission and Ro of Sars-CoV2

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: Covidcast3.21.mp3
Category:general -- posted at: 9:00pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks. So, check us*

In this episode, we cover the Society of Critical Care Medicine, Surviving Sepsis Guidelines for COVID-19

Show notes: FOAMcast.org

Thanks for listening,
Lauren Westafer and Jeremy Faust

Direct download: COVID_3.20_-_32020_7.07_PM.mp3
Category:general -- posted at: 7:15pm EDT

We interrupt our normal FOAMcast episodes to bring you updates from COVID-19, as literature develops. *Things change frequently and this may be out of date in days/weeks.

In this episode we review:

  • guidance for pregnant and breastfeeding patients and healthcare workers
  • experimental treatments that are all the craze: remdesivir, chloroquine, hydroxychloroquine, lopinavir-ritonavir

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: covid_final_maybe.mp3
Category:general -- posted at: 6:32am EDT