FOAMcast - An Emergency Medicine Podcast

Subsegmental pulmonary embolism (SSPE) is a controversial entity as they have uncertain clinical significance. As a result, the Chest Guidelines  and ACEP guidelines state that a very select group of patients with isolated SSPE and no deep vein thrombosis may be managed with surveillance rather than anticoagulation. In this podcast we review SSPE and a new prospective study by Le Gal and colleagues.

Show notes and references: FOAMcast.org

Thanks for listening!

Lauren Westafer

Direct download: SSPE_anticoagulation_-_12921_12.57_PM.mp3
Category:general -- posted at: 2:14pm EST

We review the FDA briefing document from Pfizer   as well as from the CDC Advisory Council on Immunization Practices that approved the Pfizer-BioNTech COVID-19 vaccine in children ages 5-11.


References and show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: covid_pedi_vax_5-11_-_11221_7.08_PM.mp3
Category:general -- posted at: 7:12pm EST

We previously covered the management of young febrile infants in a 2017 podcast  but now we have updated guidance from the AAP. In this podcast, we review the 2021 AAP Guidelines for the management of well-appearing febrile infants 8-60 days old, highlight practice-changing recommendations.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer

Direct download: aap_pedi_fever_-_101921_2.42_PM.mp3
Category:general -- posted at: 3:23pm EST

In this episode, Jeremy discusses what we know about breakthrough infections in the delta variant era and what this may mean for COVID-19 vaccine boosters.

Jeremy's takes can be found at Inside Medicine

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: delta_breakthrough.mp3
Category:general -- posted at: 2:34pm EST

In this episode, we discuss the current evidence (as of September 24, 2021) on COVID-19 vaccine boosters as well as the CDC recommendations and the details of the Advisory Council on Immunization Practices recommendations/vote.

Show notes/References at FOAMcast.org

Jeremy's takes can be found at Inside Medicine

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: booster_vax_covid.mp3
Category:general -- posted at: 2:06pm EST

In this literature update podcast covering important papers of 2021, we cover Becattini et al on the assessment of right ventricular dysfunction in patients diagnosed with acute pulmonary embolism (PE). We review guidelines on PE risk stratification for severity and discuss this individual patient meta-analysis.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

 

Direct download: PE_right_ventricle_dysfunction_-_81021_3.40_PM.mp3
Category:general -- posted at: 6:43pm EST

This is a quick literature update on practice-changing literature from 2021. Here we discuss Pappal et al in Annals of Emergency Medicine on awareness during paralysis in mechanically ventilated patients

Show notes / References: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: ED_awareness.mp3
Category:general -- posted at: 9:24am EST

This is a quick literature update of important literature in 2021 covering take-home naloxone by Kilaru et al. In this episode, we discuss principles of harm reduction, including naloxone, as well as the study. 

Show notes, references, and resources: FOAMcast.org

Thanks for listening!

Lauren Westafer and Jeremy Faust

Direct download: take_home_naloxone.mp3
Category:general -- posted at: 7:47pm EST

We review new clinical policy guidelines from SAEM on patients with recurrent (2 ED evaluations in 12 months) low risk (e.g. HEART score <4) chest pain.

Show notes and references: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: Foamcast_grace_chest_pain_-_7_7_21_12.11_AM.mp3
Category:general -- posted at: 8:33am EST

In this episode, we review the data on the association between myocarditis and the mRNA COVID-19 vaccines.

Show notes / References: FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: Foamcast_vaccine_myocarditis_-_6_23_21_10.28_PM.mp3
Category:general -- posted at: 6:48am EST

In this quick literature update, we review a recent paper by Branch et al on early 'panscan' (head to pelvis CT scan ) in patients with return of spontaneous circulation after out of hospital cardiac arrest. 

Show notes/ references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: OHCA_foamcast_panscan_-_6921_11.28_AM.mp3
Category:general -- posted at: 3:04pm EST

In this episode we review what we know about vaccine induced thrombotic thrombocytopenia (VITT), which has been associated with the COVID-19 viral vector vaccines by AstraZeneca and Johnson & Johnson.

Show notes/references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: VITT_-_41421_6.14_PM.mp3
Category:general -- posted at: 6:21pm EST

In this podcast, we review Cerebral Vein Thrombosis (CVT) including clinical presentation, diagnosis, and management.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: foamcast_CVT2_-_41421_8.47_PM.mp3
Category:general -- posted at: 10:10am EST

In this episode, we discuss ivermectin as a potential therapeutic for COVID-19 and review available randomized trials evaluating this drug.

Show notes: FOAMcast.org

Thanks for listening!
Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_ivermectin_for_covid.mp3
Category:general -- posted at: 9:13am EST

In this episode, we review new registry data from the ACIP meeting on pregnant people who received an mRNA COVID-19 vaccine and discuss, in general, what we know about the COVID-19 vaccines in pregnancy. 

Show notes: FOAMcast.org

Pregnancy Decision Aid

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: covid_vax_preg_update_-_3321_9.28_AM.mp3
Category:general -- posted at: 7:25pm EST

In this episode, we review the FDA briefing document on the Janssen (Johnson & Johnson) viral vector COVID-19 vaccine.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer & Jeremy Faust

Direct download: jJ.mp3
Category:general -- posted at: 9:16am EST

We have previously covered epistaxis on FOAMcast , including the use of tranexamic acid (TXA). Now, we cover a new, large RCT, the NoPac trial by Reuben et al, on TXA for epistaxis.

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: epistaxis_nopac.mp3
Category:general -- posted at: 2:10pm EST

There's been a lot of excitement over various drugs for COVID-19, including anti-inflammatory drugs. Colchicine, a medication long used for gout, fits that bill. In this podcast, we review 3 trials of colchicine including COLCORONA, GRECCO-19, and a study by Lopes et al

Show notes: FOAMcast.org

Thanks for listening!

Jeremy Faust and Lauren Westafer

Direct download: foamcast_covid_colchicine_.mp3
Category:general -- posted at: 9:28am EST

Early studies of tocilizumab, a monoclonal antibody that binds interleukin-6 , were disappointing. However, the REMAP-CAP trial recently reported a benefit to tocilizumab in non-critically ill hospitalized patients with COVID-19. Now, from the RECOVERY trial (the trial that brought us dexamethasone), we have more good news for tocilizumab - which we cover in this podcast

Show notes: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: recovery_toci_-_21321_9.45_AM.mp3
Category:general -- posted at: 9:48am EST

As vaccinations role out, the news of SARS-CoV-2 variants with mutations to the spike protein have dominated news cycles. One unanswered question has been - do the current vaccines protect against these variants?

We tackle this issue and look at a new paper [pre-print] by Wu et al

Direct download: variant_-_12521_8.55_PM.mp3
Category:general -- posted at: 8:57pm EST

Prior randomized trials of convalescent plasma in COVID-19 have had disappointing results. However, these trials included patients with severe illness who were many days (if not weeks) into the course of their illness. To date, it was hypothesized, but unknown, that the benefit would be in patients very early in the course of their illness. We cover an RCT by Libster et al in NEJM on convalescent plasma in older patients with mild COVID-19.

Show notes/references: FOAMcast.org


Thanks for listening!

Lauren Westafer and Jeremy Faust

Direct download: libster_convalescent_-_1721_7.39_AM.mp3
Category:general -- posted at: 7:41am EST

In this quick literature update we review the new recommendations from the CDC for the treatment of gonococcal infections which include:

  • Higher dose ceftriaxone (500 mg IM) or 1 gm IM if ≥150 kg patient
  • No routine azithromycin
  • Preference for doxycycline for co-treatment of presumed chlamydial infection

Show notes and references: FOAMcast.org

Thanks for listening!
Lauren Westafer and Jeremy Faust

Direct download: cdc_gonorrhea_-_1321_3.26_PM.mp3
Category:general -- posted at: 10:02am EST

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