FOAMcast - An Emergency Medicine Podcast

Diphenhydramine (Benadryl) and other first-generation antihistamines are commonly used, despite decades of data that there are safer and effective alternatives.  In this podcast, we review the guidelines / data behind common indications. References at FOAMcast.org Thanks for listening! Lauren Westafer

In this episode we review acute urticaria and new guidelines related to the treatment of urticaria. We review additional relevant trials Palungwachira et al and Barniol et al .  References/Show notes: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

In this podcast we discuss onset of action of various intramuscular agents for chemical sedation for severely agitated patients. This includes a study by Barbic et al on ketamine, the onset of action of midazolam (and association with length of stay), and is droperidol really magic? ( Cole et al )  Shownotes/References: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

Outpatient management of pulmonary embolism for low-risk patients has been encouraged for several years. However, little is known about pulmonary embolism diagnosed and managed exclusively in the outpatient setting. In this study, Vinson et al describe the course of patients diagnosed with PE and managed in the outpatient setting in an integrated healthcare delivery system. Shownotes/References: F...

The diagnostic algorithm for pulmonary embolism (PE) has evolved over the past few years to include probability or risk-adjusted D-dimer. The YEARS algorithm includes an elevated D-dimer threshold for some risk groups and has been found to be safe and reduce imaging in several studies, including in pregnant patients. Now, this multicenter trial by Freund et al evaluates use of YEARS and age-adjust...

A seminal single-center study in 2018 by Driver et al found a 98% first-pass success in patients undergoing endotracheal intubation in the Emergency Department. This multi-center randomized control trial examines bougie vs stylet in a wider array of settings Show notes/references: FOAMcast.org Thanks for listening! Lauren Westafer

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 colleague...

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

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

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

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

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 F...

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

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

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

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

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

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

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

In this episode, we discuss ivermectin as a potential therapeutic for COVID-19 and review available randomized trials evaluating this drug. Chaccour et al E-Clinical Medicine Lopez-Medina et al. JAMA Schwartz et al (not yet published) IDSA guidelines NIH Treatment guidelines Show notes: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

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

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

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

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

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 T...