FOAMcast - An Emergency Medicine Podcast

Latest Episodes:

Community Acquired Pneumonia Mar 08, 2020

Show notes

We review the evaluation and management of Community-Acquired Pneumonia (CAP) as well as the Infectious Disease Society of America (IDSA) / American Thoracic Society (ATS) 2019 guidelines for CAP.

Shownotes and references at FOAMcast.org

Thanks for listening! Jeremy Faust and Lauren Westafer

Top 5 Articles of 2019 Feb 01, 2020

Show notes

We cover some top articles of 2019, including the following:

Roc vs Sux: Guihard B et al. Effect of rocuronium vs succinylcholine on endotracheal intubation success rate among patients undergoing out-of-hospital rapid sequence intubation: A randomized clinical trial. JAMA 2019 Dec 17; 322:2303. (https://doi.org/10.1001/jama.2019.18254)

Targeted Temperature Management after Cardiac Arrest: Lascarrou JB, Merdji H, Le gouge A, et al. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019.

Pulmonary Embolism - a new D-dimer cut off Kearon C, De wit K, Parpia S, et al. Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability. N Engl J Med. 2019;381(22):2125-2134.

Pulmonary Embolism in Pregnancy: Van der pol LM, Tromeur C, Bistervels IM, et al. Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism. N Engl J Med. 2019;380(12):1139-1149.

TXA in head injury The CRASH-3 Trial Collaborators. Effects of Tranexamic Acid on Death, Disability, Vascular Occlusive Events and Other Morbidities in Patients with Acute Traumatic Brain Injury (CRASH-3): A Randomised, Placebo-Controlled Trial. Lancet 2019

VITAMINS Trial - Vitamin C, Thiamine, and Hydrocortisone in Septic Shock Jan 17, 2020

Show notes

The VITAMINS trial by Fujii et al has been published in JAMA and provides insight into the performance of the "metabolic cocktail" (Vitamin C + thiamine + hydrocortisone) in ICU patients with septic shock. We review this trial in the context of prior literature.

Show notes and references at FOAMcast.org

Thanks for listening! Jeremy Faust and Lauren Westafer

ACEP Headache Clinical Policy Dec 18, 2019

Show notes

We review the American College of Emergency Physicians (ACEP) clinical policy on headache from June 2019, most of which revolves around the diagnosis of subarachnoid hemorrhage.

Show notes and references at FOAMcast.org

Thanks for listening! Jeremy Faust and Lauren Westafer

Olanzapine + Benzodiazepines - What is the FDA warning about? Oct 29, 2019

Show notes

We are at ACEP 2019 in Denver and do a deep dive on a topic introduced by Bryan Hayes (@PharmERToxGuy) in a talk on black boxed medications used in the ED.

We review the data underlying the FDA warning for olanzapine and benzodiazepines.

Thanks for listening! Jeremy Faust and Lauren Westafer

Black Box Warnings for Common ED Medications Oct 29, 2019

Show notes

In this episode covering the American College of Emergency Physicians (ACEP) 2019, we cover common black box warnings including

fluoroquinolones
midazolam
droperidol
NSAIDs
and more

Thanks for listening!

Jeremy Faust and Lauren Westafer

Concussion and VP Shunts from ACEP 2019 Oct 27, 2019

Show notes

We are at ACEP 2019 in Denver and cover pearls from interesting lectures. Today, that included concussion and VP shunts.

Vaping Associated Lung Injury (VALI) Oct 11, 2019

Show notes

Vaping associated lung injury (VALI) has become a frequent topic in the news in the United States (US). In this episode we review the epidemiology, presumed pathophysiology, and new recommendations from the Centers for Disease Control (CDC) in the US.

Thanks for listening! Jeremy Faust and Lauren Westafer

FOAMcast.org

References:

Morbidity and Mortality Weekly Report (MMWR). 2019; 68(40)
Layden JE, Ghinai I, Pray I, et al. Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report. N Engl J Med. 2019; Sept 6.
Maddock SD, Cirulis MM, Callahan SJ, et al. Pulmonary Lipid-Laden Macrophages and Vaping. N Engl J Med. 2019;381:1488-1489.

Hyperkalemia Treatment - Insulin/Dextrose Sep 30, 2019

Show notes

In this episode we briefly review hyperkalemia and the principles of emergent treatment. Then we explore, in-depth, the role of insulin and dextrose including the incidence of hypoglycemia and pearls to reduce this side effect.

Pearls:

10-20% of patients treated with insulin/dextrose for hyperkalemia get hypoglycemic
Consider giving 5 units insulin instead of 10 units
Check the glucose for hours (dextrose lasts
Beware of insulin in patients with renal insufficiency or with near normal starting glucose.

Thanks for listening! Lauren

Droperidol and Butyrophenones Sep 01, 2019

Show notes

We discuss the US Food & Drug Administration's black box warning for droperidol and the evidence behind this warning.

We then discuss the use of butyrophenones such as droperidol and haloperidol for the treatment of agitation, headaches, nausea and vomiting, and gastroparesis/cannabinoid hyperemesis.

Thanks for listening! Jeremy Faust and Lauren Westafer