FOAMcast - An Emergency Medicine Podcast

Vaping associated lung injury (VALI) has become a frequent topic in the news in the United States (US). In this episode we review the epidemiology, presumed pathophysiology, and new recommendations from the Centers for Disease Control (CDC) in the US.

Thanks for listening!
Jeremy Faust and Lauren Westafer

FOAMcast.org

References:

  1. Morbidity and Mortality Weekly Report (MMWR). 2019; 68(40)
  2. Layden JE, Ghinai I, Pray I, et al. Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report. N Engl J Med. 2019; Sept 6.
  3. Maddock SD, Cirulis MM, Callahan SJ, et al. Pulmonary Lipid-Laden Macrophages and Vaping. N Engl J Med. 2019;381:1488-1489.
Direct download: FOAMcast_CDC_Vaping_.mp3
Category:general -- posted at: 2:31pm EDT

In this episode we briefly review hyperkalemia and the principles of emergent treatment. Then we explore, in-depth, the role of insulin and dextrose including the incidence of hypoglycemia and pearls to reduce this side effect.

Pearls:

  • 10-20% of patients treated with insulin/dextrose for hyperkalemia get hypoglycemic
  • Consider giving 5 units insulin instead of 10 units
  • Check the glucose for hours (dextrose lasts <1 hr, insulin lasts ≥2 hours)
  • Beware of insulin in patients with renal insufficiency or with near normal starting glucose.

Thanks for listening!
Lauren

Direct download: FOAMcast_hyperkalemia_and_insulin_-_9_29_19_1.52_PM.mp3
Category:general -- posted at: 9:08am EDT

We discuss the US Food & Drug Administration's black box warning for droperidol and the evidence behind this warning.

We then discuss the use of butyrophenones such as droperidol and haloperidol for the treatment of agitation, headaches, nausea and vomiting, and gastroparesis/cannabinoid hyperemesis.

 

Thanks for listening!
Jeremy Faust and Lauren Westafer 

Direct download: FOAMcast_Droperidol.mp3
Category:general -- posted at: 11:55am EDT

We discuss the coagulation test thromboelastography (TEG) / Rotational Thromboelastometry (ROTEM), reviewing the evidence behind the use of the tests as well as the clinical implications.

Show notes and graphics FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_TEG_fixed.mp3
Category:general -- posted at: 5:13pm EDT

In this episode, we discuss important and "hot" articles thus far in 2019. These articles include:

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_2019_mid_yera_literature_review.mp3
Category:general -- posted at: 11:02am EDT

We review the entity formally known as pseudoseizures and psychogenic non-epileptic seizures (PNES), now referred to as psychogenic non-epileptic attacks (PNEA). 

We discuss the history of PNEA as well as relevant literature on the diagnosis and treatment of this entity.

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_PNEA_.mp3
Category:general -- posted at: 12:45pm EDT

We review myths and reality in the management of patients with Sickle Cell Disease (SCD) 

  • Are these patients typically opioid seeking? (No)
  • If the patient appears comfortable I should withhold proper analgesia. (No).
  • Should IV fluids be a routine part of the cocktail for vaso-occlusive pain episodes? (No)

We also review common emergencies in sickle cell disease that include

  • Infections
  • Acute chest syndrome
  • Anemia (Aplastic crisis, splenic sequestration)
  • Ischemia
    • Strokes
    • Avascular necrosis
    • Renal, pulmonary, splenic infarctions
  • Vaso-occlusive pain episodes

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: FOAMcast_sickle_cell_anemia.mp3
Category:general -- posted at: 2:26pm EDT

We are at #SMACC in Sydney, Australia, thanks to the Rosh Review, delivering updates from the conference to your earbuds.

Advocacy in Emergency Medicine - Esther Choo and Hugh Montgomery

Mechanical CPR vs Manual CPR - Ken Milne vs Salim Rezaie

Super sick massive GI bleeds and balloon tamponade - Sara Gray

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_SMACC_Sydney_Day_3.mp3
Category:general -- posted at: 8:22am EDT

 We are at SMACC in Sydney, Australia, thanks to the Rosh Review, delivering updates from the conference to your earbuds. Today we cover resuscitation pearls.

Bougie vs Standard Stylet in emergency department (ED) rapid sequence intubation (RSI) - Brian Driver vs Rich Levitan

Rocuronium vs Succinylcholine Debate - Billy Mallon and Reuben Strayer

The Crashing Asthmatic - Haney Mallemat

Thanks for listening!

Lauren Westafer and Jeremy Faust

Direct download: FOAMcast_SMACC_Day_2_v2.mp3
Category:general -- posted at: 2:51am EDT

We are at #smacc in Australia thanks to the Rosh Review!

The opening session this morning was amazing and we can't do it justice on the podcast. Gill Hicks (@MadForPeace), a victim in the July 7, 2005 bombing attack on a London train spoke on how impactful everyone in the healthcare delivery system can be (from medics to detectives to nurses to physical therapists to physicians). Dr. Dara Kass delivered a powerful talk on vulnerability, responsibility, and lack of knowledge even in a super health care literate individual.....what it means to be a provider and a patient (and a mom and a medical home for the family and a wife) in her story of donating part of her liver to her son.

David Carr on anti-NMDA receptor encephalitis

 Anti-NMDA receptor encephalitis is the most common cause of encephalitis in young people (<30 years old), with an average age of ~20. We review the presentation, diagnosis, and treatment of this disease

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_SMACC_Day_1_.mp3
Category:general -- posted at: 4:32am EDT