FOAMcast - An Emergency Medicine Podcast

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 . 

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...

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

For years studies have questioned whether pulse oximeters perform as well in non-White patients as in White patients. This is particularly important now as disposition decisions in patients with COVID-19 are often made based on pulse oximetry readings. We discussed an article by Sjoding et al in NEJM  Show notes at FOAMcast.org Thanks for listening! Lauren Westafer and Jeremy Faust

Despite multiple Phase II/III vaccine trials of >30,000 participants, pregnant patients or those who are lactating have been largely excluded. In this podcast, we cover what we know (and what we don't know thus far). The Pfizer BNT162b2 trial data submitted for FDA Emergency Use Authorization does include information on a minuscule number of patients who were immunized and became pregnant. The Soc...

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 * Our understanding of COVID-19 is rapidly developing and this may be out of date in days/weeks.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 hea r* Vaccines for SARS-CoV-2 have been in development for only a few months, but several have published early results from Phase III efficacy trials in press releases. In this...

In this episode, we review cannabinoid hyperemesis syndrome and two recent randomized controlled trials on treatments Haloperidol - Ruberto et al  (Annals of Emergency Medicine, In Press) Capsaicin - Dean et al. Acad Emerg Med 2020. Show notes (references, graphics) at FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

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 hea r* Monoclonal antibodies have received significant attention over the past month and we previously podcasted on antibodies that target SARS-CoV-2. In this episode, we review...

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 hea r* Monoclonal antibodies have received significant attention over the past couple of weeks. In this episode, we review what we know, as of October 9, 2020, about monoclonal a...

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 hea r* We review a retrospective evaluation of COVID-19 infections in employees after a protocol that increased the use of high flow nasal cannula ( Westafer et al ) Show notes (...

We spoonfeed you a new article on risk stratification of pulmonary embolism (with critical appraisal pearls!) In this episode, we review a new trial by Barnes et al  on antacids versus antacids with lidocaine for epigastric pain and dyspepsia Show notes and references at  FOAMcast.org Thanks for listening, Lauren Westafer and Jeremy Faust

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 hea r* We review a new meta-analysis from the WHO REACT group of steroids in critically ill patients with COVID-19 and 3 new randomized trials of steroids in COVID-19 published i...

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 hea r* We review the evidence, to date, on convalescent plasma for the treatment of COVID-19. This includes 3 randomized trials, as well the US experience with >35,000 patients t...

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 hea r* We review Spinner et a l in JAMA 2020, an open label trial of remdesivir 5 days vs remdesivir 10 days vs 'standard of care' for the treatment of #COVID19 Show notes:  FOAM...

 We review the Ascorbic Acid, Corticosteroids, and Thiamine in Septic Shock (ACTS) Trial by Moskowitz et al in JAMA Show notes: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

We review the AAAAI 2020 anaphylaxis guideline ( Shaker et al ) A lightening review of anaphylaxis, follow by a discussion of biphasic reaction and the role of steroids and antihistamines Thanks for listening, Jeremy Faust and Lauren Westsafer

Introducing a new series of quick, spoonfed literature updates, 1 article at a time In this episode we review a new trial by Warren et al on antacids versus antacids with lidocaine for epigastric pain and dyspepsia Show notes and references at FOAMcast.org Thanks for listening, Lauren Westafer and Jeremy Faust

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 hea r* We review the RECOVERY trial results on hydroxychloroquine for COVID-19 [ pre-print by Hornby et al ] Show notes:  FOAMcast.org Thanks for listening, Lauren Westafer and J...

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 hea r* 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...

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 hea r* 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...

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 hea r* 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 Westafe...

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 hea r* 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 childre...

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 hea r* 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 Jerem...

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 hea r* 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...

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 hea r* 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 W...