@WUSTL_EM #EMConf #FOAMed Supplement No. 21

This week we had our semi-annual combined educational conference with St. Louis University Emergency Medicine.  The topic was "Myth Busters" and it was an entertaining, rapid-fire format touching on many myths in emergency medicine.  A whole lot of topics were covered. Here are #FOAMed resources related to most of them.


s1q3 in PE

- Amal Mattu covers the ECG Findings of PE, and why you should be primarily be looking for inferior & anteroseptal T wave inversions.


Kayexylate in Hyperkalemia

- Emergency Medicine News had this article by the Swami about the lack of use & potential harms in hyperkalemia.

- EM Lyceum covers the management of hyperkalemia (and why kayexalate should not be a part of it) in this post.

- The WashU EM Journal Club covered the evidence of Kayexalate for Acute Hyperkalemia in May 2011.


Coags before Paracentesis?

- FOAMcast covers approach to hepatic emergencies, including current ACEP recommendations regarding coagulopathy and performing a paracentesis.

- emdocs covers the Approach to the Sick Cirrhotic Patient.


is Droperidol dangerous?

- Everyday EBM covers the evidence (or its absence) surrounding droperidol and the risk of cardiac arrhythmia.

- The Poison Review covers the evidence that ED sedation with droperidol is relatively safe and effective.


Is the osmol Gap useful in evaluating for toxic alcohols?

- You don't understand the Osmol Gap from EMNerd & EMcrit

- emdocs covers toxic alcohols, including the time course of changes in the osmolar & anion gap: "osmolar gap will be elevated early on as the parent compound of the toxic alcohol is still present; however, it will gradually decrease, and the anion gap will increase as more toxic metabolites are formed."


DOES Lying flat after lumbar puncture and drinking plenty of fluid prevent post-LP headache?

R.E.B.E.L. EM covers Post Lumbar Puncture Headaches.  Take home: Use a smaller needle and don't worry about laying flat.


Does Trendelenberg work in Patients with Shock?

BestBets covers the LACK of evidence that Trendelenberg position to improves hemodynamics during hypovolemic shock.

Life in the Fast Lane covers some of the complications of using the Trendelenberg for the hypotensive patient.


FAST exam in the stable trauma patient

Washington University emergency medicine journal club reviewed the evidence regarding the FAST exam in the hemodynamically stable trauma patient.


AV nodal blockade in Ventricular Preexcitation

Who's Afraid of the Big Bad Wolff? from Life in the Fast Lane

ECG Medical Training gives an Intro to WPW and Associated Arrhythmmias


Do all trauma patients need rectals?

NEJM Journal watch covered why you should consider skipping the rectal exam in trauma

Life in the Fast Lane covers the subject in Adding Insult to Injury?


Patients leaving AMA?

Taming the Sru discusses the "A.I.M.E.D." approach to the patient who wants to leave AMA


Tetanus prophylaxis

EMRap covers the Mysteries of the Tetanus Shot


Tramadol for pain?

Emergency Medicine PharmD covers Three Reasons Not to Prescribe Tramadol.


IV Acetaminophen for Pain

Emergency Medicine PharmD discusses whether there is a role for IV Acetaminophen for pain management in the ED.


Can you give a third generation cephalosporin to a patient with a penicillin allergy?

Yes. You Can. EM Literature of Note covers why its okay.

ALiEM busts the myth of the 10% cephalosporin-pencillin cross-reactivity risk (Thanks to @elewMD for sharing via twitter!)


Can you give ketamine to the patient with TBI?

The SGEM covers why you can go ahead and give ketamine to the trauma patient that you are about to intubate.

Taming the Sru discusses ketamine in TBI.


Other:  Myths in Emergency Medicine from emdocs


Maia (@maiadorsett)