FOAMcast - Emergency Medicine Core Content

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 *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks.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 *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks.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 *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks.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 *Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks.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

We are going to try to bring you updates regarding COVID-19 on a regular basis. These podcasts will likely be out of date in a few days, so check back for updates.

This episode features:

  • Co-infections (extended respiratory panel positive and positive for Sars-CoV-20
  • Epidemiology of pediatric infections
  • Ibuprofen and ACE-inhibitor use

Recorded 3.18.20

Thanks for listening,

Lauren Westafer and Jeremy Faust

Direct download: Covid_3.18.mp3
Category:general -- posted at: 8:27am EDT

We review the evaluation and management of Community-Acquired Pneumonia (CAP) as well as the Infectious Disease Society of America (IDSA) / American Thoracic Society (ATS) 2019 guidelines for CAP.

Shownotes and references at FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_community_acquired_pna_-_3_8_20_6.48_PM.mp3
Category:general -- posted at: 4:39pm EDT

We cover some top articles of 2019, including the following: 

Roc vs Sux:  Guihard B et al. Effect of rocuronium vs succinylcholine on endotracheal intubation success rate among patients undergoing out-of-hospital rapid sequence intubation: A randomized clinical trial. JAMA 2019 Dec 17; 322:2303. (https://doi.org/10.1001/jama.2019.18254)

Targeted Temperature Management after Cardiac Arrest: Lascarrou JB, Merdji H, Le gouge A, et al. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019.

Pulmonary Embolism - a new D-dimer cut off Kearon C, De wit K, Parpia S, et al. Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability. N Engl J Med. 2019;381(22):2125-2134.

Pulmonary Embolism in Pregnancy: Van der pol LM, Tromeur C, Bistervels IM, et al. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. N Engl J Med. 2019;380(12):1139-1149.

TXA in head injury The CRASH-3 Trial Collaborators. Effects of Tranexamic Acid on Death, Disability, Vascular Occlusive Events and Other Morbidities in Patients with Acute Traumatic Brain Injury (CRASH-3): A Randomised, Placebo-Controlled Trial. Lancet 2019

 

Direct download: FOAMcast_lit_review_2019_.mp3
Category:general -- posted at: 8:17pm EDT

The VITAMINS trial by Fujii et al has been published in JAMA and provides insight into the performance of the "metabolic cocktail" (Vitamin C + thiamine + hydrocortisone) in ICU patients with septic shock. We review this trial in the context of prior literature.

Show notes and references at FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Vitamins_trial_.mp3
Category:general -- posted at: 6:30am EDT

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