Wed, 27 March 2019
We co-hosted (with John Vassiliadis) the SMACC EM Updates half-day conference. We had amazing speakers. Salim Rezaie spoke on TXA for Everything, Ken Milne spoke on hot papers from 2018, and we learned about when ultrasound may be helpful in pediatric lumbar punctures. In addition, Jeremy spoke on what is usual care in sepsis and Lauren spoke on pulmonary embolism: the next generation. In this short podcast we highlight some of our other talks. Aidan Baron (@Aidan_Baron) on Prehospital Updates in Cardiac Arrest This talk focused on focusing on things that are most likely to make a difference in OHCA (bystander CPR and defibrillation) rather than on fun interventions like intubation and adrenaline (epinephrine). Aidan suggests that the future debates and questions in OHCA will be largely philosophical - what outcomes do we care about: neuro intact survival or ROSC or survival?
Barbra Backus on the future of the HEART score Modified Heart Score (redefining the T or troponin based on newer assays) results in a NPV of 99.8% and classifies 48% of patients as low-risk. Clinically Relevant Adverse Cardiac Events (CRACE) is way less common than major adverse cardiac events (MACE). HEART score of ≤3 ? CRACE is 0.05% Hot Literature in 2019
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Mon, 18 February 2019
We have previously podcasted on tachyarrythmias (Episode 34 Tachyarrhythmias), but in this episode, we focus specifically on the treatment of supraventricular tachycardia (SVT), specifically paroxysmal SVT. We discuss the treatment options of adenosine and calcium channel blockers, weighing in with the evidence, the guidelines, and some opinion. Thanks for listening!
Thanks to Figure 1 for supporting this episode. We do not make money off of this podcast, this support is just for operational costs associated with the podcast. |
Thu, 31 January 2019
The US Food and Drug Administration (FDA) recently released another warning for fluoroquinolones, this time regarding aortic dissection and aneurysm. We review the evidence behind this warning, including the following studies: Lee CC Risk of Aortic Dissection and Aortic Aneurysm in Patients Taking Oral Fluoroquinolone. JAMA Intern Med. 2015;175(11):1839-47. Lee CC Oral Fluoroquinolone and the Risk of Aortic Dissection. J Am Coll Cardiol. 2018;72(12):1369-1378. Pasternak B Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study. BMJ. 2018;360:k678. We then review the ACEP clinical policy on aortic dissection covering risk scores, d-dimers, and management of aortic dissection Thanks for listening! Jeremy Faust and Lauren Westafer
Direct download: FOAMcast_Fluoroquinilons_and_the_aorta_v2.mp3
Category:general -- posted at: 6:59am EDT |
Thu, 27 December 2018
We cover the clinical policy from the American College of Emergency Physicians - Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events?
In adult patients with suspected acute non–ST-elevation acute coronary syndromes, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events?
In adult patients with suspected acute non–ST-elevation acute coronary syndromes in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography [CT] angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events?
Should adult patients with acute non–ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events?
Thanks for listening!
Direct download: FOAMcast_ACS_ACEP_guideline_with_definition_fix.mp3
Category:general -- posted at: 2:12pm EDT |
Tue, 20 November 2018
We discuss Medicated Assisted Treatment (MAT) for opioid use disorder (OUD) including buprenorphine initiated from the emergency department. This show was sponsored by Figure 1, a free open access application for providers using images and cases Thanks for listening! Jeremy Faust and Lauren Westafer References:
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Mon, 22 October 2018
The Free Open Access Medical Education (FOAM) world is often obsessed with magnesium. In this show we address the use of magnesium for various applications. Magnesium for Acute Atrial Fibrillation with Rapid Ventricular Response (RVR)
Magnesium for Migraine
Magnesium for Acute Asthma Exacerbation Griffiths B, Kew KM. Intravenous magnesium sulfate for treating children with acute asthma in the emergency department. Cochrane Database Syst Rev. 2016;4:CD011050.
Thanks for listening! Jeremy Faust and Lauren Westafer |
Tue, 16 October 2018
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! |
Wed, 3 October 2018
We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight:
Thanks for listening! |
Tue, 2 October 2018
We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight:
Thanks for listening! |
Mon, 1 October 2018
We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight:
Thanks for listening!
Direct download: FOAMCast_Pediatrics_Head_Trauma_from_ACEP18_San_Diego_Day_1_.mp3
Category:general -- posted at: 6:15pm EDT |