FOAMcast -  An Emergency Medicine Podcast artwork

FOAMcast - An Emergency Medicine Podcast

256 episodes - English - Latest episode: about 1 month ago - ★★★★★ - 222 ratings

We believe in the educational merits of Free Open Access Medical education (FOAM), which includes podcasts, blogs, articles on PubMed Central, conferences streamed for free and more. As a result, we would like to encourage others to move beyond quoting podcasts and into the realm of tying “cutting edge” FOAM to the core content. We’ll provide some review and references for listeners to go read. Why, indeed, should we FOAM it alone when FOAM can inspire us to go, read, think, and be excellent?

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Episodes

Topical Anesthetics in Corneal Abrasions - A Consensus Guideline from ACEP

February 16, 2024 17:27 - 20 minutes - 27.9 MB

In this episode, we review a consensus guideline from the American College of Emergency Physicians on the use of topical anesthetics in corneal abrasions.  Show notes and references: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren WEstafer

Atrial Fibrillation Guideline Update from the AHA

December 13, 2023 17:29 - 18 minutes - 26 MB

This episode covers emergency medicine-related recommendations from the American Heart Association's (AHA) clinical guideline on atrial fibrillation: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation Circulation. 2023 Show notes and references: FOAMcast.org Thanks for listening! Lauren Westafer

Tranfusion Thresholds in Myocardial Infarction

December 05, 2023 20:58 - 16 minutes - 22.8 MB

The AABB recently published updated recommendations for blood transfusion thresholds. This podcast reviews these recommendations and a recent study, the MINT trial, in which patients with anemia and a myocardial infarction were randomized to a restrictive strategy or liberal transfusion strategy. Show notes / references: FOAMcast.org Thanks for listening! Lauren Westafer

ACEP Clinical Policy: Sedation of the Agitated Patient

December 01, 2023 19:11 - 14 minutes - 20.4 MB

This epsiode reviews the new clinical policy from the American College of Emergency Physicians (ACEP) on medication for acutely agitated patients needing parenteral sedation. Show notes / references: FOAMcast.org Thanks for listening! Lauren Westafer

REBOA: Resuscitative Endovascular Balloon Occlusion of the Aorta

October 17, 2023 19:06 - 21 minutes - 29.7 MB

In this episode, we review Resuscitative endovascular balloon occlusion of the aorta (REBOA), notably dissecting the recent Jansen et al trial in JAMA. Shownotes / References:  FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

Naltrexone for Alcohol Use Disorder

September 06, 2023 12:38 - 17 minutes - 23.9 MB

Alcohol use disorder (AUD) is commonly encountered in the ED and visits related to alcohol are estimated to be ~4% of all ED visits in the US. Despite this, most EDs offer little support and harm reduction for patients with AUD. In this podcast, we review naltrexone, the first-line medication for patients with AUD, which is starting to be initiated in US EDs by emergency clinicians.  AAEM position paper References and show notes: FOAMcast.org Thanks for listening! Lauren Westafer

Steroids for Severe Community Acquired Pneumonia

March 27, 2023 15:58 - 11 minutes - 15.9 MB

Recommendations for the use of steroids in community-acquired pneumonia have been mixed. This episode reviews a large multicenter randomized trial in the New England Journal of Medicine by Dequin et al on hydrocortisone for severe community-acquired pneumonia.  References/show notes: FOAMcast.org Thanks for listening! Lauren Westafer

CLOVERS Trial: Restricted vs Liberal Fluids in Sepsis-Induced Hypotension

February 15, 2023 13:11 - 20 minutes - 28.3 MB

In this episode we review the CLOVERS trial, a randomized trial of early (first 24 hours) restrictive versus liberal fluids.  Show notes/references: FOAMcast.org Thanks for listening! Jeremy Faust + Lauren Westafer

Management of Acute, Uncomplicated Diverticulitis

February 03, 2023 19:16 - 18 minutes - 25.1 MB

This episode reviews guideline recommendations and literature on the management of acute, uncomplicated diverticulitis - highlighting the recommendations to only prescribe antibiotics to select patients. References/Show Notes: FOAMcast.org Thanks for listening! Lauren WEstafer

The "Diamond of Death" in Trauma - Hypocalcemia

January 25, 2023 15:15 - 16 minutes - 22.3 MB

This episode reviews a shift from the "lethal triad" in trauma to the "diamond of death," exploring the role of calcium in hemostasis and critically ill patients. We review the literature that is available on hypocalcemia and trauma patients References/show notes: FOAMcast.org Thanks for listening! Lauren Westafer

A Cardiac Arrest Story: Patient Interview

January 24, 2023 20:07 - 29 minutes - 40 MB

This episode is a departure from the typical FOAMcast clinical content, we will be back with strictly clinical content soon. In May 2022, I came across a fellow passenger and stranger in cardiac arrest in the airport. A small team of strangers, including an emergency medicine resident, Dr. Jason Tanner, and an emergency department technician, Angel, assembled to treat this passenger. Billy Frolick, a writer and our patient that day, shares his perspective on his case with us.  In additio...

ACEP Heart Failure Clinical Policy & High Dose Nitrates

January 20, 2023 15:41 - 25 minutes - 35.7 MB

This episode covers the 2022 American College of Emergency Physicians (ACEP) clinical policy on acute heart failure syndromes with a special focus on high dose nitrates References and Show Notes: FOAMcast.org Thanks for listening! Lauren Westafer

Refractory Ventricular Fibrillation & Double Sequential Defibrillation

December 03, 2022 13:30 - 27 minutes - 24.8 MB

In this episode, we review the largest trial of double sequential external defibrillation (DSED) and vector change (VC) defibrillation for refractory ventricular fibrillation (VFib): Cheskes S, Verbeek PR, Drennan IR, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022;387(21):1947-1956. Show notes, references, & infographics: FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

STEMI Equivalent Update - 2022 ACC Consensus Statement

October 18, 2022 16:52 - 14 minutes - 19.6 MB

The American College of Cardiology released a new consensus statement endorsing several signs on the electrocardiogram (ECG) as "STEMI Equivalents." In this podcast, we review these signs. Show notes / graphics / references: FOAMcast.org Thanks for listening! Lauren Westafer

Pulse Checks During Cardiopulmonary Resuscitation

September 03, 2022 19:36 - 14 minutes - 20.3 MB

Since 2010, the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) have de-emphasized pulse checks - such that they recommend against routine pulse checks. Despite this recommendation, may individuals and institutions continue to perform pulse checks. This episode reviews the recommendations and the literature. References/show notes: FOAMcast.org Thanks for listening! Lauren Westafer

Monkeypox Quick Summary

July 29, 2022 18:09 - 9 minutes - 12.7 MB

There is a global outbreak of human monkeypox virus cases. In this episode we provide a quick summary of monkeypox to date. Check out our two more in-depth episodes on the topic.  References/Show notes: FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

Monkeypox - Clinical Manifestations, Treatments, & Vaccination

July 29, 2022 17:53 - 15 minutes - 20.9 MB

There is a global outbreak of human monkeypox virus cases. In this episode (the second of a 2 part series), we summarize clinical manifestations, complications, and vaccination.  References/Show notes: FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

Monkeypox - Virology, Epidemiology, and Transmission

July 29, 2022 17:18 - 11 minutes - 15.2 MB

There is a global outbreak of human monkeypox virus cases. In this episode (the first of a 2 part series), we summarize some brief virology, epidemiology, and review the transmission of this virus.  References/Show notes: FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer

Management of Hemmorhoids

July 23, 2022 11:23 - 15 minutes - 28.1 MB

We review the Anorectal emergencies: WSES-AAST guidelines on complicated hemorrhoids that include some practice-changers References: FOAMcast.org Thanks for listening! Lauren Westafer

The End of Diphenhydramine

June 08, 2022 17:42 - 18 minutes - 25.2 MB

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

Urticaria

March 11, 2022 19:30 - 17 minutes - 24.6 MB

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

Intramuscular Agents for Severe Agitation

January 23, 2022 18:32 - 21 minutes - 29.5 MB

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

Primary Care Management of Pulmonary Embolism

January 15, 2022 20:03 - 14 minutes - 19.3 MB

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: FOAMcast.org Thanks for listening! Lauren Westafer

Lit Update: Pulmonary Embolism Diagnosis Update

January 15, 2022 15:04 - 8 minutes - 11.4 MB

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-adjusted D-dimer compared with an age-adjusted approach alone. Shownotes/References: FOAMcast.org ...

Lit Update: Bougie vs Stylet for Endotracheal Intubation

January 15, 2022 14:41 - 8 minutes - 12.1 MB

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

December 09, 2021 19:14 - 13 minutes - 18.1 MB

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 colleagues. Show notes and references: FOAMcast.org Thanks for listening! Lauren Westafer

COVID-19 Vaccine in Children Ages 5-11

November 02, 2021 23:12 - 19 minutes - 26.3 MB

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

Febrile Infants 8-60 days Old - AAP Guidelines

October 19, 2021 19:23 - 19 minutes - 26.3 MB

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

COVID-19 Delta Variant and Vaccine Breakthrough Infections

September 24, 2021 18:34 - 11 minutes - 15.3 MB

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

COVID-19 Vaccine Boosters

September 24, 2021 18:06 - 17 minutes - 23.6 MB

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

Pulmonary Embolism Risk Stratification - Right Ventricular Dysfunction

August 10, 2021 22:43 - 15 minutes - 21.7 MB

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 Faust  

Awareness With Paralysis in Mechanically Ventilated Patients

August 09, 2021 13:24 - 10 minutes - 15 MB

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

Harm Reduction in Opioid Use Disorder: Take Home Naloxone

August 08, 2021 23:47 - 12 minutes - 17.8 MB

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

Recurrent Low-Risk Chest Pain GRACE Guidelines

July 07, 2021 12:33 - 26 minutes - 48.8 MB

We review new clinical policy guidelines from SAEM on patients with recurrent (2 ED evaluations in 12 months) low risk (e.g. HEART score <4) chest pain. Show notes and references: FOAMcast.org Thanks for listening! Jeremy Faust and Lauren Westafer

Myocarditis and COVID-19 mRNA Vaccines

June 24, 2021 10:48 - 20 minutes - 37.4 MB

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

Panscan after Out of Hospital Cardiac Arrest

June 08, 2021 19:04 - 19 minutes - 26.2 MB

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

Covidcast: Vaccine Induced Thrombotic Thrombocytopenia

April 14, 2021 22:21 - 18 minutes - 24.9 MB

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

Cerebral Vein Thrombosis

April 14, 2021 14:10 - 15 minutes - 20.7 MB

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

COVIDcast: Ivermectin

April 06, 2021 13:13 - 26 minutes - 48.5 MB

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

COVIDcast - Pregnancy & Vaccine Update

March 03, 2021 00:25 - 21 minutes - 29.1 MB

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

COVIDcast - Janssen (J&J) COVID-19 Vaccine

February 26, 2021 14:16 - 19 minutes - 26.8 MB

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

Tranexamic Acid in Epistaxis

February 21, 2021 19:10 - 17 minutes - 23.8 MB

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

COVIDcast - Colchicine in COVID-19

February 16, 2021 14:28 - 26 minutes - 48.4 MB

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

COVIDcast - Tocilizumab [RECOVERY trial]

February 13, 2021 14:48 - 12 minutes - 17.2 MB

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 Thanks for listening! Lauren Westafer and Jeremy Faust

COVID Vaccine and Variants

January 26, 2021 01:57 - 7 minutes - 10 MB

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. 

COVIDcast: Convalescent Plasma in Older Outpatients with Mild COVID-19

January 07, 2021 12:41 - 5 minutes - 8.2 MB

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 plasma in older patients with mild COVID-19. Show notes/references: FOAMcast.org Thanks for...

Gonococcal Infection Treatment Update

January 03, 2021 15:02 - 8 minutes - 11.6 MB

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

Racial Bias in Pulse Oximetry

December 18, 2020 18:52 - 8 minutes - 11.3 MB

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

COVIDcast- SARS-CoV-2 mRNA Vaccines and Pregnancy

December 09, 2020 18:54 - 14 minutes - 20.4 MB

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 Society for Maternal and Fetal Medicine has released statements on vaccines in SARS-CoV-2. In...

COVIDcast: SARS-CoV-2 Vaccine Update

November 30, 2020 03:30 - 25 minutes - 34.4 MB

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 hear* 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 episode, we review these vaccines and what we know about them, and what we know about  them Sh...

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