Tuesday, May 12, 2015

@WUSTL_EM #EMConf: #FOAMed Supplement No. 2

Welcome to @WUSTL_EM #EMConf, the #FOAMed Edition. The purpose of this weekly column is to identify #FOAMed resources that reinforce and expand on the concepts/facts discussed during weekly conference.  Please e-mail wuemresidents@gmail.com to share additional resources (or just post them as comments below).
This week in @WUSTL_EM #EMConf ....

1. Neurology Core Content with Education Resident Sean Cavanaugh:
- see this post from EM Lyceum on tPA in ischemic stroke (including blood pressure management, age cutoffs etc.) as well as this one on  management of intracranial hemorrhage.
 - In patients with vertigo and concern for posterior circulation stroke, learn to perform the HINTS exam.  Our own EM Journal Club reviewed the HINTS exam in this podcast, with supplemental videos provided on the website.
- Get certified to perform the NIH Stroke Scale correctly by working through the online module provided by the National Stroke Association here.
- Good resources for "on the shift" reminders of the NIH stroke scale and contraindications to tPA are ALiEM's PV cards on the subject.

- I highly recommend this post from EM Lyceum covering pharmacologic management of seizures, imaging in first time seizure, and diagnosis of pseudoseizures.
-ALiEM has some good resources regarding phenytoin loads: this "Trick of the Trade" post on single dose oral load for phenytoin in the ED and this one on understanding phenytoin equivalents.
- EM basic has this podcast on general seizure management and this post on febrile seizures.

2. Sepsis: Shock & Awe with Dr. Wes Watkins
 - Rebel EM did this post summarizing the results of the ProMISe, ARISE, and ProCESS trials.  If you prefer the podcast version, you can listen to the RebelCast here.
- SGEM evaluated the ProMISe trial in  Podcast #113
- Our own blog advocated a balanced approach to fluid choice for resuscitation in sepsis in this post.
- Approach to assessment of volume status with ultrasound via the Ultrasound Podcast.

3. Physostigmine for Anticholingeric Toxicity with Dr. Wes Watkins:
 - Life in the Fast Lane gives a "how to administer" for physostigmine.
 - A further review of use of physostigmine for anticholingeric toxicity from the EM Pharm D blog.

4. Difficult Diagnosis with Maureen Gross - we discussed the "gray area" of diagnosis of septic arthritis.  For further reading regarding this difficult-to-make diagnosis see Chris Carpenter's 2013 review in EP Monthly. Also check out this emdocs post on septic arthritis as well.

5. Sleep Cycle with Maureen Gross: Could not find much FOAMy material on the subject, but you can check out this review article on sleep cycle and pharmacologic sleep aids for the emergency physician.

6. Ortho Radiology with Dr. Ruoff: Northwestern has this great Ortho teaching website that allows one to work through a series of cases.


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