FOAMcast - An Emergency Medicine Podcast
256 episodes - English - Latest episode: 5 months ago - ★★★★★ - 222 ratingsWe 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 MBIn 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 MBThis 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 MBThe 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 MBThis 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 MBIn 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 MBAlcohol 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 MBRecommendations 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 MBIn 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 MBThis 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 MBThis 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 MBThis 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 MBThis 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 MBIn 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 MBThe 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 MBSince 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 MBThere 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 MBThere 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 MBThere 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 MBWe 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 MBDiphenhydramine (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 MBIn 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 MBIn 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 MBOutpatient 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 MBThe 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 MBA 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 MBSubsegmental 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 MBWe 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 MBWe 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 MBIn 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 MBIn 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 MBIn 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 MBThis 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 MBThis 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 MBWe 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 MBIn 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 MBIn 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 MBIn 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 MBIn 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 MBIn 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 MBIn 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 MBIn 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 MBWe 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 MBThere'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 MBEarly 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 MBAs 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 MBPrior 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 MBIn 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 MBFor 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 MBDespite 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 MBWe 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...