FOAMcast - Emergency Medicine Core Content

In this episode we highlight key articles in Emergency Medicine that came out, thus far, in 2018.

D'souza et al. Effects of prophylactic anticholinergic medications to decrease extrapyramidal side effects in patients taking acute antiemetic drugs: a systematic review and meta-analysis Emerg Med J. 2018;35(5):325-331.

Driver et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. JAMA. 2018;319(21):2179-2189.

Atkinson PR, Milne J, Diegelmann L, et al. Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators. Ann Emerg Med. 2018; In press.

Perkins GD et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med 2018; 379:711-721

Meltzer et al. Effect of Tamsulosin on Passage of Symptomatic Ureteral Stones: A Randomized Clinical Trial. JAMA Intern Med. 2018 Aug 1;178(8):1051-1057

Kabrhel et al Multicenter Evaluation of the YEARS Criteria in Emergency Department Patients Evaluated for Pulmonary Embolism. Acad Emerg Med. 2018;25(9):987-994

 

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMCast_2018_literature_review.mp3
Category:general -- posted at: 11:30am EDT

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA.

In this episode we highlight:

  • Myths in diagnostic imaging
    • Torsion ultrasound is insensitive
    • CTPA for PE is not perfect. There are false positives AND false negatives
  • Myths in pediatrics
    • Response to antipyretics does NOT make viral infection more likely
    • Juice in kids with gastroenteritis is a great way to rehydrate them
    • Kids don't have to wait 24 hours on antibiotics for strep throat before returning to school, if they got 50 mg/kg amoxicillin prior to 5pm the night before, they're fine

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMCast_ACEP18_San_Diego_Day_3_.mp3
Category:general -- posted at: 5:14pm EDT

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA.

In this episode we highlight:

  • Problems with CYA (Cover your a$$) medicine such as admissions
  • Problems with lactate, procalcitonin, and other biomarkers

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMCast_ACEP18_San_Diego_Day_2_.mp3
Category:general -- posted at: 8:07pm EDT

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA.

In this episode we highlight:

  • Severe pediatric brain injury, tips for management and preventing badness
  • Aortic dissection diagnostics
  • Chest tube pearls

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMCast_Pediatrics_Head_Trauma_from_ACEP18_San_Diego_Day_1_.mp3
Category:general -- posted at: 6:15pm EDT

We cover a JAMA Clinical Reviews podcast on lyme disease, including some myth-busters.

*Doxycycline can be used, safely, in kids < 8 years old

*Testing for lyme is a mess because : (1) we test patients with ultra low probability of disease (2) we test patients who shouldn't be tested (i.e. have erythema migrans) (3) the tests are a pain to interpret

*Lyme disease is spreading further south and west in the US, into Canada, and it's also increasingly found in Europe.

We then delve into core content for Rosen's, Tintinalli, and the IDSA 2006 guidelines.

Thanks for listening!
Jeremy Faust and Lauren Westafer

FOAMcast.org

 

 

Direct download: FOAMCast_Lyme_v2.mp3
Category:general -- posted at: 9:27am EDT

We review the American Urological Association guidelines on penile fracture and priapism. We supplement this with core content from Tintinalli and Rosen's Emergency Medicine.

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

We review one of the editors top picks from Annals of Emergency Medicine, which are free for 6 months from issue release.  The article covered in this podcast is Waldman et al, is a study of tetracaine in corneal abrasions.

We also review commonly encountered corneal emergencies:

Corneal abrasions

Corneal ulcers

and herpes keratoconjunctivitis.

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Annals_Corneal_Abrasion__v2.mp3
Category:general -- posted at: 8:24am EDT

Show notes at FOAMcast.org

We cover the 2017 IDSA/SHEA guidelines on clostridium difficile (c diff).

We then review core content on c diff including risk stratification and treatment using Rosen's and Tintinalli as guides.

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_C_diff.mp3
Category:general -- posted at: 2:32am EDT

Workup for pulmonary embolism (PE) is common (perhaps too common) in the United States. The American College of Emergency Physicians has released a clinical policy on pulmonary embolism. We cover this policy as well as core content on PE risk stratification and "rule out"

Thanks for listening,
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_ACEP_policy_on_VTE_and_PE.mp3
Category:general -- posted at: 10:02am EDT

We cover the emergency department care of lactating patients including

Medications during breastfeeding - who should "pump and dump"? (spoiler: very few people, check LactMed or InfantRisk)

Mastitis & Breast Abscesses

Emergency Department Support

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_lactation_.mp3
Category:general -- posted at: 9:30pm EDT