FOAMcast - Emergency Medicine Core Content

We are in Berlin for #dasSMACC and have lots of pearls to share from the speakers at this amazing conference.  Talks will be released for free on the SMACC podcast over the next year, but this podcast holds some pearls that we thought couldn't wait.

We cover...

Dr. Leanne Harnett on Pulmonary Embolism with Right Heart Thrombus (PE with RHT)

Dr. Michele Domico on Pediatric Cardiology Emergencies

Dr. Haney Mallemat (@CriticalCareNow) on Transesophageal Echocardiography (TEE) during Cardiac Arrest


Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_DasSMACC_Day_2._TEE_in_codes_PE_with_RH_thrombus_SCAPE.mp3
Category:general -- posted at: 1:11pm EDT

We deliver pearls from the first day of #dasSMACC in Berlin.

We cover talks by Dr. Brian Burns on trauma, Dr. David Carr on endocarditis, Dr. Paul Young on statistics, and Dr. Jess Mason on sickle cell vaso-occlusive crisis.

Check out for show notes and pictographic summaries.

Thanks for listening and for the Rosh Review for sending us!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_DasSMACC_Day_1._Endocarditis.mp3
Category:general -- posted at: 2:14pm EDT

We interrupt our normal core content for this update:

Texting amongst medical professionals is ubiquitous; however, given patient privacy laws, many wonder, what is permissible?

We discuss a recent article in JAMA by Brian Drolet on this very topic as well as some basic professionalism pearls.

Show notes at

Thanks for listening,

Lauren Westafer and Jeremy Faust

Direct download: FOAMcast_texting_and_patient_privacy_VERSION_2.mp3
Category:general -- posted at: 8:56am EDT

We cover FOAM on the WOMAN trial of tranexamic acid (TXA) in post-partum hemorrhage including BroomeDocsEMlitofnote, and The Bottom Line

Then we delve into core content on non-pregnant vaginal bleeding using Rosen's and Tintinalli's as a guide.

Show notes are available at

Thanks for listening!
Lauren Westafer & Jeremy Faust

Direct download: Foamcast_WOMAN_and_dysfunctinoal_uterine_bleeding.mp3
Category:general -- posted at: 5:24pm EDT

We cover Free Open Access Medical Education (FOAM) from a recent Emergency Medicine Cases podcast and First10inEM blog post by Dr. Justin Morganstern regarding urinary tract infections (UTIs).   This podcast and blog tackle common issues in UTI diagnosis and treatment, including the following points:

  • UTI is a clinical diagnosis, a dirty urine does not mean the patient has a UTI
  • Urinalyses are more complicated to interpret than we probably understand

Then we cover core content from Rosen’s Emergency Medicine (8th ed), Chapter 99; Tintialli's Emergency Medicine (8th ed), Chapter 91; IDSA Guidelines for Treatment and Asymptomatic Bacteriuria

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: Foamcast_episode_68_UTI_.mp3
Category:general -- posted at: 11:42am EDT

 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 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 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 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