FOAM Supplement!

Hi team, we had two weeks of special conference time, namely the highly successful Larry Lewis (not memorial) Symposium on the Opiate Crisis, and mock oral boards. 


Oral Boards

Foundations: Pulmonary

Pelvic Ultrasound

EMS Grand Rounds

Toxicology: Alcohol Withdrawal

FOAM Supplement 8/14/2017

EM Foundations: EKGs

CPC - I can't breathe

Pediatric Case

Pediatric Sickle Cell

  • We see only the tip of the iceberg among sickle cell patients. It's important to remember that the factors that lead to some patients being "non-compliant", "fired from clinic" or labeled as drug seeking are the same factors that make this small portion of patients more likely to present to the emergency department. EM:RAP's Jess Mason recorded a great piece a few months about an adult man with sickle cell disease that really drives home the point that shouldn't have to be made: patients with sickle cell disease have a severe life-limiting disease that involves pain beyond what most people can imagine. 

Alcoholic Ambushes

Suicidality in EMS Providers

  • Mental health is finally getting some traction in our field. If you're feeling depressed or having thoughts of suicide please reach out before it's too late. Talk to a trusted colleague, PD, or Chair. If you're a friend to a physician colleague who seems to be struggling, say something. You don't have to be on shift to save a life. 


FOAM Supplement 8/7/2017

Pulmonary Foundations

Links courtesy of one of our new interns, John Schneider!

Thoracic Imaging


Chest Radiography


Return of the FOAM Supplement 8/1/2017

After a summer recess, we're making a return of the FOAM supplement!

Core Content: Pulmonary

  • Lots of great resources from Foundations on the ALIEM AIR Series.

Echo & EKG

  • Nothing can match Dr. Ablordeppey's delivery of the content, but here are some resources that are in the same vein


  • EM Crit has a new section dedicated to sepsis management, I highly recommend checking it out. 

Leadership in Trauma

  • I listened to this podcast my intern year and it has stuck with me ever since. This podcast is directed toward medical codes and floor codes, but many of the leadership principles are the same.


  • The ever popular ED ECMO site has tons of resources on all things ECMO

FOAM Supplement 2/7/2016

FOAM Supplement 1/10/2017

FOAM Supplement 1/3/2016

FOAM MegaSupplement

FOAM supplement 11/01/2016

@WUSTL_EM #FOAM #EMConf 10/12/2016

….And we’re back, after a brief hiatus the FOAM supplement is here once again!

Immune Complex:

Vent management

Case Presentations

EMS and the DEA

@WUSTL_EM #EMConf #FOAMed Supplement No. 41

@WUSTL_EM #EMConf #FOAMed Supplement No. 40


NonST Elevation ACS & ECMO

Source: 2014 AHA/ACC NSTE-ACS guidelines (emphasis mine)


MSK & Radiology of the Hip


@WUSTL_EM #EMConf #FOAMed Supplement No. 39

@WUSTL_EM #EMConf #FOAMed Supplement No. 38

@WUSTL_EM #EMConf #FOAMed Supplement No. 37



Trauma & Teamwork

Stroke Protocol


@WUSTL_EM #EMConf #FOAMed Supplement No. 36

1. Core Content: Cutaneous Disorders

 2. In the Hunt: Job Search in EM

 3. Tachy-Dysrhythmia Cases

Note: I’ve been told that a “small child with ADHD in City Museum could focus longer than you” - we hear a lot of the concepts from the first half of this lecture repeatedly. The second half is equally high yield - consider starting in the middle and looping back.

Just for our own Dr. Kolinsky:

4. MSK:Ankle/Leg/Foot

- Adam Rieves, PGY-1


@WUSTL_EM #EMConf #FOAMed Supplement No. 35

@WUSTL_EM #EMConf #FOAMed supplement No. 34

Palliative Care

This brief talk by Ashley Shreves, entitled "Diagnosing Dying" showcased on the intensive care network is an excellent resource for an emergency physician.


testicular torsion

emdocs covers the Pearls & Pitfalls of Testicular torsion in this post.

If you prefer a more bulleted format, Core EM covers the diagnosis & management of testicular torsion as well.

Sonoguide covers the basics of bedside testicular ultrasound.


Peds Interesting Case:   Hair Grooming Syncope

Believe it or not, the FOAMed world has tackled this one.  See this peds em morsels post on hair grooming syncope.

For an approach to cardiac syncope, our own blog has this post on the can't miss EKG findings in a young patient with syncope.



Where to start?  The crew at Boring/CanadiEM made this great infographic on the Top 5 updates to the AHA guidelines.

Rebel EM discusses the how-to of double sequential defibrillation for refractory Vfib arrest.

EMS world covers the history of heads-up CPR.

This post on Dr. Smith's ECG blog (entitled "A perfect resuscitation saves a patient") sounds like it may have been plucked from DK's dreams (although it does not include TEE).


Age Adjusted d-dimer

EM Cases covers Age Adjusted d-dimer in the Journal Jam podcast.

Age adjusted d-dimer was covered by Brian Cohn in our own Washington University Emergency Medicine journal club & podcast.


Ultrasound:  Right Upper Quadrant

The ultrasound podcast covers gallbladder ultrasound.

Check out this interesting case from Ultrasound Case of the Week.



Maia Dorsett (@maiadorsett)

@WUSTL_EM #EMConf #FOAMed Supplement No. 33


1. 4th year grand rounds: intubating the asthmatic

- EM Lyceum discusses adjuncts to the management of asthma in this post.

- The EMCrit Dominating the Vent series has this fantastic review.  Listen, watch and take notes (and then scan your notes into your phone for quick reference).

- Since great minds think alike, the topic of the Core EM podcast this week is none other than Ventilating the Intubated asthmatic.


2.  Abscesses

- The Mayo EM blog argues that we should not be packing abscesses.

- EM Lyceum covered the literature on abscess packing and the loop drainage technique in this post.


3. Surgical airway

there are a plethra of #FOAMed resources on surgical airway.   Consider watching this Vodcast by Rich Levitan on the decision to perform & how to perform a cricothyroidotomy.


4. Cognitive Errors & Stress Innoculation

This week em mindset covers cognitive load theory.  A useful read for any EM physician.

EMCrit covered David Grossman's On Combat in the EMCrit Bookclub episode.

Listen to what Mike Lauria has to say about stress innoculation.


5.  The Foot

Detecting the fractures: Radiopedia reviews an approach to radiology of the foot, with links to more extensive discussions of important fracture patterns.

Northwestern's Orthopedic teaching site also has this case-based review of foot cases.

Nerve blocks to help reduce them:

Ultrasound podcast covers the Tibial Nerve Block and Sciatic and Ankle Blocks.


Enjoy & please comment if you have additional resources to share,



@WUSTL_EM #EMConf #FOAMed Supplement No. 32

1. INteresting cases - TTP

- emdocs has this nice review of TTP physiology, diagnosis and management (including mention of cardiac complications).


2. Pediatric Airway

- emdocs has both this article on general pearls and pitfalls of the pediatric airway, and another on management of the pediatric patient with airway obstruction.

- If you prefer podcasts, check on this EM:RAP episode on difficult pediatric airways or this one from the pem.ed podcast.


3. Central Venous Catheter Complications

- Listen to EMCrit podcast 156 on avoiding central line complications and podcast 157 on central placement tips.


4. Gout

- If you're inclined, go ahead and review The American College of Rheumatology 2012 guidelines on the management of gout.

- The Mayo Clinic EMBlog has this excellent post on the diagnosis and treatment of gout in the ED.  Importantly, it discusses the importance of considering the important alternative diagnosis of septic arthritis.

- The Poison Review discusses colchicine dosing in acute gout and why you should probably stick to the lower dose.


5. Critical Care Scholar Track - Sepsis 3.0

Step one:  Before reading or listening to the podcasts and blogs, read The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) paper for free in JAMA.

Step two:  check out these blog posts and podcasts discussing the new definitions:

    - FOAMcast: Sepsis Redefined

    - REBEL EM : Sepsis 3.0

    - Scott Weingart discusses Sepsis 3.0 with Melvin Singer

    - PulmCrit discusses the Top 10 Problems with the new sepsis score.

.... and remember, CMS has not changed over to this new definition.  So when it comesto documentation, the SIRS-based, three-tier system of sepsis, severe sepsis & septic shock still stands.



Maia (@maiadorsett)