FOAMcast - An Emergency Medicine Podcast

We are at #smacc in Australia thanks to the Rosh Review ! The opening session this morning was amazing and we can't do it justice on the podcast. Gill Hicks (@MadForPeace), a victim in the July 7, 2005 bombing attack on a London train spoke on how impactful everyone in the healthcare delivery system can be (from medics to detectives to nurses to physical therapists to physicians). Dr. Dara Kass de...

We co-hosted (with John Vassiliadis) the SMACC EM Updates half-day conference. We had amazing speakers. Salim Rezaie spoke on TXA for Everything , Ken Milne spoke on hot papers from 2018 , and we learned about when ultrasound may be helpful in pediatric lumbar punctures. In addition, Jeremy spoke on what is usual care in sepsis and Lauren spoke on pulmonary embolism: the next generation. In this s...

We have previously podcasted on tachyarrythmias ( Episode 34 Tachyarrhythmias) , but in this episode, we focus specifically on the treatment of supraventricular tachycardia  (SVT),  specifically paroxysmal SVT. We discuss the treatment options of adenosine and calcium channel blockers, weighing in with the evidence, the guidelines, and some opinion. Thanks for listening! Lauren Westafer and Jeremy...

The US Food and Drug Administration (FDA) recently released another warning for fluoroquinolones, this time regarding aortic dissection and aneurysm.   We review the evidence behind this warning, including the following studies: Lee CC   Risk of Aortic Dissection and Aortic Aneurysm in Patients Taking Oral Fluoroquinolone . JAMA Intern Med. 2015;175(11):1839-47. Lee CC  Oral Fluoroquinolone and th...

We cover the clinical policy from the American College of Emergency Physicians -  Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Non–ST-Elevation Acute Coronary Syndromes In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse...

We discuss Medicated Assisted Treatment (MAT) for opioid use disorder (OUD) including buprenorphine initiated from the emergency department. This show was sponsored by  Figure 1 , a free open access application for providers using images and cases Thanks for listening! Jeremy Faust and Lauren Westafer References: Berg ML, Idrees U, Ding R, Nesbit SA, Liang HK, and McCarthy ML. Evaluation of the us...

 The Free Open Access Medical Education (FOAM) world is often obsessed with magnesium. In this show we address the use of magnesium for various applications. Magnesium for Acute Atrial Fibrillation with Rapid Ventricular Response (RVR) Bouida et al. LOw dose MAGnesium sulfate versus HIgh dose in the early management of rapid atrial fibrillation: randomised controlled double blind study . Acad Emer...

In this episode we highlight key articles in Emergency Medicine that came out, thus far, in 2018. D'souza et al.  Effects of prophylactic anticholinergic medications to decrease extrapyramidal side effects in patients taking acute antiemetic drugs: a systematic review and meta-analysis  Emerg Med J. 2018;35(5):325-331. Driver et al.  Effect of Use of a Bougie vs Endotracheal Tube and Stylet on Fir...

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight: Myths in diagnostic imaging Torsion ultrasound is insensitive CTPA for PE is not perfect. There are false positives AND false negatives Myths in pediatrics Response to antipyretics does NOT make viral infection more likely Juice in kids with gastroen...

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight: Problems with CYA (Cover your a$$) medicine such as admissions Problems with lactate, procalcitonin, and other biomarkers Thanks for listening! Jeremy Faust and Lauren Westafer

We bring you pearls from the American College of Emergency Physicians (ACEP) 2018 Scientific Assembly in San Diego, CA. In this episode we highlight: Severe pediatric brain injury, tips for management and preventing badness Aortic dissection diagnostics Chest tube pearls Thanks for listening! Jeremy Faust and Lauren Westafer

We cover a  JAMA Clinical Reviews podcast  on lyme disease, including some myth-busters. *Doxycycline can be used, safely, in kids < 8 years old *Testing for lyme is a mess because : (1) we test patients with ultra low probability of disease (2) we test patients who shouldn't be tested (i.e. have erythema migrans) (3) the tests are a pain to interpret *Lyme disease is spreading further south and w...

We review the American Urological Association guidelines on penile fracture and priapism.  We supplement this with core content from Tintinalli and Rosen's Emergency Medicine.

We review one of the editors top picks from Annals of Emergency Medicine, which are free for 6 months from issue release.  The article covered in this podcast is  Waldman et al , is a study of tetracaine in corneal abrasions. We also review commonly encountered corneal emergencies: Corneal abrasions Corneal ulcers and herpes keratoconjunctivitis. Thanks for listening! Jeremy Faust and Lauren Westa...

Show notes at FOAMcast.org We cover the 2017 IDSA/SHEA guidelines on clostridium   difficile (c diff). We then review core content on c diff including risk stratification and treatment using Rosen's and Tintinalli as guides. Thanks for listening! Jeremy Faust and Lauren Westafer

Workup for pulmonary embolism (PE) is common (perhaps too common) in the United States. The American College of Emergency Physicians has released a clinical policy on pulmonary embolism. We cover this policy as well as core content on PE risk stratification and "rule out" Thanks for listening, Jeremy Faust and Lauren Westafer

We cover the emergency department care of lactating patients including Medications during breastfeeding - who should "pump and dump"? (spoiler: very few people, check LactMed or InfantRisk) Mastitis & Breast Abscesses Emergency Department Support Thanks for listening! Jeremy Faust and Lauren Westafer

Show notes at FOAMcast.org We have a special April 1st show - the Faust-Westafer Central Theorem of Emergency Medicine. Listen for details Thanks for listening! Jeremy Faust and Lauren Westafer

We review select articles from 2017 that are important or that got people talking including: Sadeghirad B et al. Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials . BMJ. 2017;358:j3887. Barniol et al .Levocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Tr...

We tackle some free open access medical education from the CDC on the flu vaccine, including: Recommendations that individuals with any severity of egg allergy (including anaphylaxis) receive the flu vaccine. The only modification that needs to occur is patients with a history of true anaphylaxis to eggs should be given the flu shot in a setting where they can be monitored by a healthcare professi...

Over at the Pulmcrit blog, Dr. Josh Farkas has proposed the use of phenobarbital monotherapy  for the treatment of ethanol withdrawal and we cover this protocol. We then dive into core content alcohol withdrawal using Rosen's Emergency Medicine (9th ed) Chapter 142 , Tintinalli's Emergency Medicine (8th ed) Chapter 292, and Goldfrank's Toxicologic Emergencies (10th ed) Chapter 81  as guides. Thank...

We discuss ultrasound diagnosis of pneumoperitoneum using a podcast from 5MinSono. Then we delve into core content on gastritis, PUD, and helicobacter pylori using Rosen's Ch 78 and Tintinalli's Ch 79 as guides. Thank for listening! Jeremy Faust and Lauren Westafer

We cover Free Open Access Medical Education (FOAM) on mass casualty incidents, an unfortunate reality in the current United States climate (and elsewhere).  There is a must read (truly, emergency providers really should read this) in EP Monthly by Dr. Kevin Menes, " How One Las Vegas ED Saved Hundreds of Lives After the Worst Mass Shooting in U.S. History ". He details his process in running the E...

We bring you pearls from the American College of Emergency Physicians (ACEP) 2017 Scientific Assembly. We cover in-flight emergencies, need for contrast enhanced CT scans, bronchiolitis and sucrose for infants Thanks for listening! Jeremy Faust and Lauren Westafer

We bring you pearls from the American College of Emergency Physicians (ACEP) 2017 Scientific Assembly. Pearls on H. Pylori from: It's Alimentary - Poo-Pourri of Conditions From the Mouth to Rectum - Dr. Adebayo, Dr. Batra, Dr. Bavokek Emerging Infections: Zika and Its Friends - Dr. Joan Noelker High Yield Toxicology - Dr Erickson, Dr Traub, Dr. Perrone