To build on my “Intro to FOAMed” lecture from Tuesday, I
thought I would use the Digest this week to highlight some of the
highest-quality resources out there for those of you just dipping your toes
into the FOAMy goodness. You can’t go wrong adding these to your Feedly.
Well-referenced, expert review, open discussion with prompt response – they’re
really setting the bar for the FOAMed world.
And don’t worry – in the spirit of FOAMed the lecture and
slides will be posted as soon as the video editing is done.
Now come on in, the water’s fine!
Three Stars:
1. Academic Life in EM (ALiEM) continues to be one of the
paragons of the FOAMed community. Check out this “Diagnose on Sight” case from
this week – don’t want to give it away, but you will see it time and time again
during your Children’s shifts. Make note of the reference list and
pre-publication review from a practicing clinician. Supremely high quality.
2. I must credit my inspiration for this FOAMed Digest –
the LITFL Review from Life in the Fast Lane. Curated by some of the sharpest
tacks around, it’s a great way to get familiar with the variety of resources
out there. Lots of good stuff this time around, including links to Amal Mattu’s
EKG video review of QT prolongation, the latest edition of FOAMCast (all about
the spleen!), and the St. Emlyn’s view of the new NICE guidelines for managing
acute heart failure.
EXTRA CREDIT: If you need help keeping up with the EM primary
literature, the Research & Reviews in the Fastlane segment is a great place
to start!
3. EM Lyceum takes the “flipped classroom” concept to the next level. Every month or so, they publish a series of clinical questions focused on a particular topic. This time, it was trauma. The point is to ponder those questions, discuss them in a group, and maybe even do your own research. The EM Lyceum group then publishes the best evidence-based answers they could find in an exceptionally well-referenced summary. Pearl from this month: Bust out the PCC for ICH on warfarin, but no good evidence for PCC in your “average” coagulopathic trauma patient.
Oldie But Goodie:
This post isn’t actually that old, but it’s about older
patients, so we’re gonna count it. On the heels of Dr. Galante’s lecture from
last month, Ken Milne at the Skeptics’ Guide to Emergency Medicine takes on
Chris Carpenter’s systematic review of ED tool to predict fall risk ingeriatric patients from this months Annals.
This is a can’t-miss episode, as it is the initial
installment of the “Hot Off The Press” series. You can watch in real-time as
the FOAMed and published-journal worlds start to merge. Each episode of this
series will feature a critical analysis and interview with an author of a paper
just published in Annals or CJEM. The audience (i.e., everyone) will
have a chance to respond with their own post-publication peer review via social
media outlets. The top responses will be featured in a future publication in
each journal. Knowledge translation and crowdsourced feedback at the speed of
social media!
F(FN)OAMed:
If you’re going to pick one podcast to listen to
religiously, that podcast should probably be EM:RAP. This month, be sure to
check out the segment on IV contrast myths.
Take-home points: Iodine is not an allergen. Seafood
allergy does not increase risk of anaphylaxis to IV contrast any more than any
other given allergy, although previous reaction to IV contrast or past history
of atopy does increase risk. And most notably – premedication with steroids has
not been shown to decrease the number of severe reactions.
The Gunner Files:
1. Check out Scott Weingart’s interview with Dr. John Hinds
regarding his approach to the patient with blunt traumatic arrest.
In Dr. Hinds’ shop, before they do anything else they: 1)
intubate, 2) perform bilateral finger thoracostamies, 3) place a pelvic binder,
4) reduce any gross long-bone deformities, 5) start uncrossmatched transfusion.
Only then do they start a formalized assessment. Really interesting stuff.
2. Similar to the R&R from the Fastlane mentioned
above, Ryan Radecki’s EM Lit of Note blog is another excellent version of a
curated primary literature review. Here is his critical appraisal summary of a systematic
review and meta-analysis comparing trauma “pan scan” with more selective
imaging.
3. The most recent installment of the EM BASIC podcast is
your panic-free look at what we know about Ebola – screening, clinical signs
& symptoms, diagnosis, isolation, and treatment.
4. The ultimate skeptic, Rory Spiegel of EM Nerd, turns his
nihilistic eye towards the cash cow of cardiac interventionalists everywhere –
PCI. Turns out, there’s not a lot of evidence to support its use outside the
realm of emergent intervention for STEMI.
5. In the most recent podcast on Emergency Medicine Cases,
an EM sports medicine specialist and an orthopedic surgeon help you to avoid falling prey to the “Commonly Missed (Uncommon) Orthopedic Injuries.” Want to know how not
to miss a DRUJ? Lisfranc? Perilunate? Tune in.
Never stop learning,
C. Sam Smith, PGY-3
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