We review gastroparesis treatment with haloperidol including a recent study by Ramirez and colleagues. This study had significant methodologic limitations but provides some interesting insight into a practice that many providers have adopted - using haloperidol for gastroparesis. A tiny RCT by Roldan and colleagues also looked at this practice and found promising results, although the study was very small. Haloperidol has also been used in cannabinoid hyperemesis but literature on this is limite...
Sep 01, 2017•24 min
We review recent discussions on the accuracy of cuff blood pressures including a meta-analysis Picone et al published in the Journal of the American College of Cardiology discussing the accuracy of cuff blood pressures. We cover core content on hypertensive emergencies and asymptomatic markedly elevated blood pressure using the ACEP clinical policy on hypertension, Rosen's (9th ed) Chapter 74 "Hypertension," and Tintinalli (8th ed), Chapter 57 “Systemic Hypertension” Chapter 59 “Aortic Dissectio...
Aug 18, 2017•22 min
We cover Free Open Access Medical Education on opioids. The Poison Review podcast reviews papers on the opioid epidemic, including a paper by Rudd et al demonstrating an increase in opioid-related deaths over the past five years as well as the following paper by Shah and colleagues. The Dantastic Mr. Tox and Howard , a new podcast on the scene, also covers multiple topics on opioids, including common misconceptions of tramadol. Then we cover core content on opioid overdose and withdrawal using R...
Jul 31, 2017•28 min
We are in Berlin for #dasSMACC and have lots of pearls to share from the speakers at this amazing conference. Talks will be released for free on the SMACC podcast over the next year, but this podcast holds some pearls that we thought couldn't wait. We cover... One of the major themes of #dasSMACC has been - we are more overconfident in our knowledge, skills, ability, and good behavior than we actually demonstrate. We cover the Dunning-Kruger effect and how to help combat the notion that "this ha...
Jun 29, 2017•16 min
We are in Berlin for #dasSMACC and have lots of pearls to share from the speakers at this amazing conference. Talks will be released for free on the SMACC podcast over the next year, but this podcast holds some pearls that we thought couldn't wait. We cover... Dr. Leanne Harnett on Pulmonary Embolism with Right Heart Thrombus (PE with RHT) Dr. Michele Domico on Pediatric Cardiology Emergencies Dr. Haney Mallemat (@CriticalCareNow) on Transesophageal Echocardiography (TEE) during Cardiac Arrest T...
Jun 28, 2017•29 min
We deliver pearls from the first day of #dasSMACC in Berlin. We cover talks by Dr. Brian Burns on trauma, Dr. David Carr on endocarditis, Dr. Paul Young on statistics, and Dr. Jess Mason on sickle cell vaso-occlusive crisis. Check out foamcast.org for show notes and pictographic summaries. Thanks for listening and for the Rosh Review for sending us! Jeremy Faust and Lauren Westafer
Jun 27, 2017•17 min
We interrupt our normal core content for this update: Texting amongst medical professionals is ubiquitous; however, given patient privacy laws, many wonder, what is permissible? We discuss a recent article in JAMA by Brian Drolet on this very topic as well as some basic professionalism pearls. Show notes at FOAMcast.org Thanks for listening, Lauren Westafer and Jeremy Faust...
Jun 05, 2017•12 min
We cover FOAM on the WOMAN trial of tranexamic acid (TXA) in post-partum hemorrhage including BroomeDocs , EMlitofnote , and The Bottom Line Then we delve into core content on non-pregnant vaginal bleeding using Rosen's and Tintinalli's as a guide. Show notes are available at FOAMcast.org Thanks for listening! Lauren Westafer & Jeremy Faust...
May 15, 2017•23 min
We cover Free Open Access Medical Education (FOAM) from a recent Emergency Medicine Cases podcast and First10inEM blog post by Dr. Justin Morganstern regarding urinary tract infections (UTIs). This podcast and blog tackle common issues in UTI diagnosis and treatment, including the following points: UTI is a clinical diagnosis, a dirty urine does not mean the patient has a UTI Urinalyses are more complicated to interpret than we probably understand Then we cover core content from Rosen’s Emergenc...
May 06, 2017•30 min
A recent study in Academic Emergency Medicine by Hughes and colleagues , looks at the potential clinical relevance of having emergency physicians sign ECGs read "normal" by the computer software. FOAM reviews of this article can be found here: Dr. Smith's ECG blog Emergency Medicine Literature of Note REBEL EM Then we review ischemia on ECGs, including STEMIs as well as a dive into ischemic T waves Check out FOAMcast.org for more show notes and images. Thanks for listening! Lauren Westafer and J...
Apr 26, 2017•26 min
We cover an episode of The Skeptic's Guide to Emergency Medicine that covers a validation study of the Step by Step approach to pediatric fever. This approach to infants with a fever <3 months old is alluring as it does not necessitate a lumbar puncture. This algorithm had a better sensitivity and negative predictive value than the Rochester criteria. The approach did miss some infants with a serious bacterial infection and these tended to be those between 21 and 28 days old and those with fe...
Mar 31, 2017•23 min
We cover a post from the fantastic St. Emlyn's team which breaks down a recently published article in Annals of Emergency Medicine comparing diazepam with placebo in patients with acute low back pain. We recommend you read the full text of the article by Friedman et al . We delve into core content on red flags in back pain and spinal epidural abscess using Rosen's Emergency Medicine and Tintinalli's Emergency Medicine Chapter 279 as a guide. visit FOAMcast.org for show notes and more information...
Mar 12, 2017•29 min
We cover Free Open Access Medical Education (FOAM) on Contrast-Induced Nephropathy (CIN). Recent interes The American College of Radiology (ACR) Manual on Contrast Induced Nephropathy This Emergency Medicine Literature of Note post covers the AMACING trial , which looks at intravenous fluid administration (0.9% NaCl) versus usual care in patients "at risk" for CIN undergoing contrast-enhanced CT scan. The study found a difference of -0.1% (95% CI -2.25 to 2.06), which was below the non-inferiori...
Feb 28, 2017•23 min
Ultrasound is gaining popularity in assisting lumbar punctures (LPs). We review this technique as well as Free Open Access Medical Education (FOAM) from the following sites: 5 Min Sono , Sinai EM , and PEM pearls from ALiEM . We then delve into core content on meningitis, encephalitis, and antiNMDA receptor encephalitis using Rosen's Chapter 109 and Tintinalli's Chapters 117 and 174 as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer...
Feb 18, 2017•28 min
We cover FOAM on transvenous pacing from Ultrasound Podcast , Dr. Jason Nomura , and Dr. Al Sachetti Then, we delve into basics on bradycardias using Rosen's Emergency Medicine and Tintinalli's as a guide. Thanks for listening! Jeremy Faust and Lauren Westafer...
Jan 24, 2017•23 min
The Surviving Sepsis Campaign Guidelines were updated, reflecting some changes carried forward from Sepsis 3.0 that was released in 2016. In this podcast we go over some of the updates, many of the recommendations that stayed the same. As a bonus we cover a new study on validation of qSOFA. Show notes at FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer...
Jan 19, 2017•19 min
A lot of good literature came out in 2016 so we wanted to mention a couple of our favorite articles of the year. Sepsis 3.0 Singer M, Deutschman CS, Seymour CW, et al: The Sepsis Definitions Task Force The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) . The quick SOFA score (qSOFA) also came out in hopes it "provides simple bedside criteria to identify adult patients with suspected infection who are likely to have poor outcomes." It is not part of the sepsis de...
Jan 01, 2017•16 min
We review a trick of the trade from Academic Life in Emergency medicine for temporomandibular joint (TMJ) dislocation , the extra-oral reduction as well as other methods of TMJ reduction. We delve into core content on dental injuries including fractures, avulsion, luxations, pulpitis and more using Rosen’s Emergency Medicine (8th edition) Chapter 70 "Oral Emergencies" and Tintinalli’s Emergency Medicine (8th edition) Chapter 245 "Oral and Dental Emergencies" as a guide. Thanks for listening! Jer...
Dec 20, 2016•25 min
We review a podcast from Dr. Tim Horeczko's Pediatric Emergency Playbook on elbow injuries including identifying normal ossification centers (CRITOE), radial head subluxation, and supracondylar fractures. Then, we delve into core content on other elbow adjacent injuries including elbow dislocations, humerus fractures, and olecranon bursitis using Rosen’s Emergency Medicine (8th edition) Chapter and Tintinalli’s Emergency Medicine (8th edition) Chapter as a guide. Thanks for listening! Jeremy Fau...
Dec 13, 2016•22 min
We review a talk by Dr. Sara Gray from SMACC (Social Media and Critical Care) conference in June 2016, Resuscitative hysterotomy , which is the new name for perimortem c-section [1]. In this talk she challenges the "4 minute" rule: if resuscitative efforts following maternal circulatory arrest are unsuccessful, cesarean delivery should be commenced at 4 minutes and completed by 5 minutes to optimize fetal outcome. Then we delve into core content on pregnancy emergencies using Rosen’s Emergency M...
Nov 25, 2016•23 min
The PESIT study in the New England Journal of Medicine stirred up controversy in the FOAM world earlier in October 2016. In this episode we cover the following posts on this article on pulmonary embolism in syncope: Dr. Rory Spiegel of EMnerd Dr. Ryan Radecki of EM Literature of Note St. Emlyn's Rebel EM Then, We delve into core content on syncope usingRosen's Emergency Medicine (8th edition) and Tintinalli's Emergency Medicine (8th edition) Chapter 52 Thanks for listening! -Jeremy Faust and Lau...
Oct 31, 2016•24 min
We are bringing y'all pearls from ACEP 2016 in Las Vegas. Today we cover Bell's Palsy (are you sure it's not a stroke?), burn dogma, and some hot abstracts of the year. Thanks for listening! Jeremy Faust and Lauren Westafer
Oct 19, 2016•10 min
We are at ACEP 2016 summarizing the hottest pearls Today we cover placebos in the ED for back pain, nausea, and upper respiratory tract infections as well as atrial fibrillation management controversies and vaccine side effects. Thanks for listening! Jeremy Faust and Lauren Westafer
Oct 18, 2016•11 min
We bring you highlights from ACEP2016 in Las Vegas. Today we focus on the care of the transgender patient and some pearls on caring appropriately for our diverse patients. We also cover active shooters and lawsuit pearls Thanks for listening! Jeremy Faust and Lauren Westafer
Oct 17, 2016•11 min
We cover an incredible ophthalmology resource, OphthoBook.com , by Dr. Tim Roots. This resource has a free book and excellent free video lectures . Specifically, we detail a hilarious video on eye exam tricks , especially targeting individuals who "can't see." We previously reviewed eye trauma in this podcast . In this episode, we review ophthalmology basics using Tintinalli’s Emergency Medicine (8e), Chapter 241 Visit FOAMcast.org for more and Rosh Review questions. Thanks for listening! Jeremy...
Oct 09, 2016•24 min
The Free Open Access Medical Education (FOAM) We cover a post from Dr. Josh Farkas on PULMcrit on lithium toxicity. The key message from the post is: a single serum lithium level doesn't necessitate dialysis, despite a recommendation from the EXTRIP working group to initiate dialysis in patients with a lithium level > 5 mEq/L [1]. Dr. Farkas advocates for aggressive management in asymptomatic patients with chronic lithium toxicity and patients without impaired renal function. Core Content We ...
Oct 02, 2016•22 min
We review a FOAM post by Dr. Matthew MacPartlin on Rollcage Medic on flying after a pneumothorax . Then we delve into a core content review of altitude sickness, high altitude pulmonary edema, high altitude cerebral edema, and altitude related problems using Tintinalli and Rosen's Emergency Medicine as a guide. Thanks for listening! -Jeremy Faust & Lauren Westafer
Sep 06, 2016•21 min
We cover several excellent post on rashes, including: Paucis Verbis Approach to Rashes - ALiEM Emergent Diagnosis of the Unknown Rash from EMJ What's That Rash? - EMdocs Next, we dive into core content on platelet problems including problems caused by drugs, immune thrombocytopenic purpura (ITP/idiopathic thrombocytopenic purpura) and thrombotic thrombocytopenic purpura (TTP) using Tintinalli Chapter 233 (8th ed) and Rosen's Chapter 122 (7th ed) as a guide. Thanks for listening! Jeremy Faust and...
Aug 23, 2016•24 min
We cover ultrasound guided pericardiocentesis using the posts from EMin5 , CoreEM , and the Ultrasound Podcast . Then, we delve into core content on the pericardium using Rosen’s (8th ed) Chapter 82 and Tintinalli (8th ed) Chapter 55 covering pericardial effusions, pericarditis, and myocarditis. Thanks for listening! Jeremy Faust & Lauren Westafer...
Aug 08, 2016•21 min
We cover a post by Dr. Rory Spiegel, EMNerd: The Case of Differing Perspectives , on the results of the ATACH-2 trial on blood pressure control in intracranial hemorrhage (ICH). This study sought to determine the safety and efficacy of the Population : adults (>18 y/o) with ICH on CT scan, GCS ≥ 5 and <4.5 hours since symptom onset (changed mid-study) Intervention : Reduce and maintain the hourly minimum systolic blood pressure in the range of 110 to 139 mm Hg throughout the period of 24 h...
Jul 17, 2016•23 min
