FOAMcast - An Emergency Medicine Podcast (general)

This week we cover posts from the Wessex ICS site, The Bottom Line, which is an excellent source for breakdown of recent and important trials. We cover their post on a systematic review of peripheral pressor complications (Loubani et al) and then we delve into a recent prospective trial by Cardenas-Garcia and colleagues that came up at SMACC.

Then we review peripheral vasopressors using Tintinalli and Rosen's Emergency Medicine as a guide. 

We have Rosh Review questions and more available on our website, FOAMcast.org.


Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_31._Pressors.mp3
Category:general -- posted at: 9:39am EDT

ACEP released an updated clinical policy on the use of tPA for acute ischemic stroke in June 2015.  We reviewed this on a prior episode. While we are not an interview based show, we had to seize the opportunity to talk with those with more experience. 

In this episode, Jeremy interviews Dr. Jerry Hoffman, a notorious tPA critic.

We shall return to regular core content soon.

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_Jerry_Hoffman.mp3
Category:general -- posted at: 8:45pm EDT

FOAMcast is bringing you pearls from conferences we attend including SMACC.  (and next June 13-16, we'll bring you pearls from smaccDUB in Dublin, Ireland)

Today we discuss some pearls on shift work, analgesia (even without drugs), the perils of the Glasgow Coma Scale and more!

Direct download: FOAMcastini_SMACC_day_3.mp3
Category:general -- posted at: 8:41pm EDT

FOAMcast is bringing you pearls from conferences we attend including SMACC.  (and next June 13-16, we'll bring you pearls from smaccDUB in Dublin, Ireland)

Today we discuss some pearls on pediatric fluids, impact apnea, evidence based medicine, and death.

 

Direct download: FOAMcastini_SMACC_day_2.mp3
Category:general -- posted at: 8:14pm EDT

FOAMcast is bringing you pearls from conferences we attend including SMACC.  

The overarching theme to Day 1 at SMACC?  Use your team-to check you and for feedback.  Dr. Cliff Reid reminded us to follow up our patients and outcomes and learn from it all, without letting our egos get in the way.   Dr. Simon Carley (St. Emlyn's) gave a powerful talk on learning from mistakes later in the day; you will definitely want to listen to these when they come out.

We cover trauma pearls from Dr. Scott Weingart, pain pearls from Dr. Reuben Strayer, tox pearls form Dr. David Juurlin, and a bunch of sepsis goodness. 

Direct download: FOAMcastini_SMACC_day_1.1.mp3
Category:general -- posted at: 10:14pm EDT

We review this post from Dr. Scott Weingart's EMCrit podcast on Thyroid Storm.

Then, we delve into core even more content pearls on the thyroid including differentiating different hyperthyroid states and mxyedema coma.  We do this using Tintinalli and Rosen's as guides. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_30_Thyroid.mp3
Category:general -- posted at: 7:29pm EDT

We review this  post from Dr. Anton Helman of Emergency Medicine Cases on Pediatric DKA

Then, we delve into core content pearls on hyperglycemia including Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State.  We do this using Tintinalli and Rosen's as guides. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_29._DKA_and_HHS.mp3
Category:general -- posted at: 7:30pm EDT

This episode is slightly different.  We review some of our favoite pearls from the last year including our favorite mnemonics and memory aids (and some that we think bombed).

Thanks, y'all, for listening, providing feedback, and continuing to inspire us to look through FOAM and Rosenalli to enhance our emergency medicine education.

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMCastini_One_year.mp3
Category:general -- posted at: 10:06am EDT

We review thisa post from Dr. Charles Bruen of Resus Review on Malignant Hyperthermia and dantrolene.

Then, we delve into core content pearls on polypharmacy -  serotonin syndrome, neuroleptic malignant syndrome, and extrapyramidal side effects.  We do this using Tintinalli and Rosen's as guides. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_28_NMS_MH_and_Serotonin_Syndrome_edited.mp3
Category:general -- posted at: 7:10pm EDT

We review this post from the amazing Maryland Critical Care Project on N-acetylcysteine for Inhalational Burn Injury

Then, we delve into core content pearls on  burns including nomenclature, fluid resuscitation, burn center referral criteria, and more.  We do this using Tintinalli and Rosen's as guides. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_27_Burns.mp3
Category:general -- posted at: 1:38pm EDT

We review use of longboards and cervical collars for spinal immobilization using the  new ACEP statement and posts by ScanCrit (Curse of the Cervical Collar, Cervical Collar RIP,  Cervical Collars Slashed From Guidelines), a post by Dr. Minh Le Cong from PHARM, and this Medest118 post (in addition to new policy statement from ACEP) 

Then, we delve into core content pearls on differentiating spinal shock from neurogenic shock, the incomplete cord syndromes such as anterior cord syndrome, central cord syndrome, and Brown Sequard syndrome, as well as a quick and dirty review of key spinal reflexes.  We do this using Tintinalli, and Rosen's as a guide. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_26_Spine.mp3
Category:general -- posted at: 9:11pm EDT

We review the post by Bryan Hayes, PharmD, FAACT on Academic Life in Emergency Medicine,  Sulfamethoxazole-Trimethoprim for Skin and Soft Tissue Infections: 1 or 2 Tablets BID? 

Then, we delve into core content pearls on cellulitis and abscesses, necrotizing skin infections, and Erythema Multiforme/Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis using the IDSA guidelines, Tintinalli, and Rosen's as a guide. 

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_25._MRSA_cellulitis_and_skin_FIXED.mp3
Category:general -- posted at: 11:12pm EDT

This week we're covering Dr. Jacob Avila's post on ultrasound for small bowel obstruction (SBO)  located at Ultrasound of the week.  He has an accompanying video on 5minSono.

Screen Shot 2015-01-25 at 10.20.44 AM

The Bread and Butter

We cover key points on SBO and Acute Mesenteric Ischemia from Rosenalli, that’s Tintinalli (7e) Chapter 86; Rosen’s (8e) Chapter 92.  But, don’t just take our word for it.  Go enrich your fundamental understanding yourself.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_SBO.mp3
Category:general -- posted at: 9:45pm EDT

This week we review Dr. Josh Farkas's PulmCrit blog posts, Renal microvascular hemodynamics in sepsis: a new paradigm and Renoresuscitation: Sepsis resuscitation designed to avoid long-term complications in which he posits that renal protection in sepsis may prove beneficial for patients.  

Then, we delve into core content pearls on acute kidney injury using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide) as a guide.  

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_21._Acute_Renal_Failure.mp3
Category:general -- posted at: 10:24pm EDT

This week we review Dr.Ken Milne's podcast, the Skeptics Guide to Emergency Medicine new feature - Hot off the Press. It's all about geriatric falls, y'all.

Then, we delve into core content pearls on the geriatrics using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).  We review polypharmacy, abdominal pain, and other key pearls.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_18_Falls_and_Geriatrics.mp3
Category:general -- posted at: 12:28am EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

ACEP is revisiting the TPA policy - Dr. David Newman, Dr. Edward Sloan, and Dr. Seaberg

Evidence based approach to Intracerebral Hemorrhage by Dr. Jon Edlow

Drs. Jerome Hoffman and Richard Bukata delivered key literature pearls.

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Wednesday.mp3
Category:general -- posted at: 8:03pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

HIV patients are at risk for ACS and thrombotic complications

Resuscitation pearls from Weingart:  Don't trust "normal" vital signs, ACLS is not for emergency physicians, REBOA and ECMO are coming

Palliative care in the Emergendy Department - important and often not well done

ACEP has 5 more "Chosing Wisely" Pearls

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Tuesday_.mp3
Category:general -- posted at: 5:47pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  

Today's Pearls:

Emergency Physicians are like economists (We're more probalisticians than diagnosticians).

Cardiology pearls from Dr. Slovis - TTM to 36 Celsius post-arrest should be standard. Many people probably could benefit from caths after arrest, we're not sure exactly who at this point.

Patients returning from West Africa with fever probably have a regular virus, maybe malaria, but probably not ebola.

There's really not much use for glucagon in calcium channel blocker toxicity. Think supportive care, insulin-dextrose.

ETCO2 - it doesn't equal PaCO2 and it depends on cardiac output and alveolar ventilation  

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Monday_.mp3
Category:general -- posted at: 6:59pm EDT

FOAMcast is bringing you pearls from conferences we attend and, first up, the American College of Emergency Physicians annual meeting, ACEP14.  However, Jeremy and I both worked overnights so we got into town a little late.  Our friends and ACEP luminaries, Drs. Justin Hensley, Howie Mell, and Todd Slesinger.

For updates, follow #ACEP14

 

Thanks for listening, y'all!

Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_ACEP14_Sunday_Day_1.mp3
Category:general -- posted at: 10:21pm EDT

In this tiny episode, Jeremy gives his bottom line pearls for FOAMcast episodes 4-14.  You know, because spaced repetition is a good thing.  We've got anaphylaxis, heart failure, ebola, acid-base, and more.

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcastini_3._Episode_4_to_14_Pearls.mp3
Category:general -- posted at: 9:18pm EDT

This week we review EM in 5's episode on the hand neuro exam.

Then, we delve into core content hand pearls including flexor tenosynovitis, extensor tendon injuries, amputations, and more using Rosenalli (Rosen's Emergency Medicine and Tintinalli's Emergency Medicine: A Comprehensive Review Guide).

Key Texts: Tintinalli (7e): Ch 280, 295; Rosen's (8e) Ch 50

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Direct download: FOAMcast_Episode_14._Hand_neuro_revised.mp3
Category:general -- posted at: 12:16am EDT

This week we review Dr. Natalie May's brilliant post on the St. Emlyn's blog, "When Sick Means Sick: Emesemantics and Vomiting in Kids"  in which she dissects emesis descriptors such as bilious, projectile, and coffee-ground.

Then, we delve into core content on Neonatal Jaundice and Intussusception.

Key Texts: Tintinalli (7e) Chapters 111, 124 ; Rosen's (8e) Chapter 172

As always, visit foamcast.org for show notes and the generously donated Rosh Review questions.

Thanks y'all!

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_10_Peds_vomiting.mp3
Category:general -- posted at: 6:26pm EDT

On this FOAMcastini (A tiny FOAMcast), we summarize our summaries of core content and free open access medical education (FOAM), covering:

Episode 1 - Cyanide and Carbon Monoxide Toxicity

Episode 2 - All things GU (Renal colic, urinary retention, infected stones)

Episode 3 - ENT (Bullous myringitis, ruptured tympanic membranes, auricular hematomas, and more).

This is our attempt at remembering these things ourselves and encouraging some spaced repetition. Thanks for listening and just remember, no need to FOAM it alone.

-Jeremy Faust and Lauren Westafer

Direct download: Foamcastini_1_ep._1_to_3.mp3
Category:general -- posted at: 7:00am EDT

We review the FOAM from The RAGE podcast (The Resuscitationist's Awesome Guide to Everything), "Episode 4" ,on impact apnea, the right heart and more.  Then we discuss the core content related to right ventricular myocardial infarctions and heart failure.

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:  Tintinalli (7e) Chapters 53, 57; Rosen’s (8e) Chapters 78, 81

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_7._RAGE_Heart_Failure.mp3
Category:general -- posted at: 7:46am EDT

Episode 3 - SMART EM and Ear Emergencies

We review FOAM (Free Open Access Medical education), SMART EM "Pseudoaxioms 2 and Literature Update," in which Dr. David Newman discussesthe lack of benefit for tamsulosin in most renal colic.  Then, we discuss core content urologic emergencies including:

  • Bullous Myringitis
  • Perforated Tympanic Membrane
  • Auricular Hematoma
  • Necrotizing Otitis Externa (Malignant Otitis Externa)

As always, visit foamcast.org  for show notes and the generously donated Rosh Review questions.

Key Texts:

Tintinalli's Emergency Medicine: A Comprehensive Study Guide (7e) Chapter 237

Rosen's Emergency Medicine(8e) Chapter 92

Thanks for listening!

 

-Jeremy Faust and Lauren Westafer

Direct download: FOAMcast_Episode_3._SMART_EM_Bullous_Myringitis_060114.1401.mp3
Category:general -- posted at: 7:00am EDT