Standing on the corner, minding my own business in the ER

Hyperkalemia myths from EMLyceum

Hi all, Short post today, as I just want to acknowledge the great work of another blog over at EMLyceum. The myths of hyperkalemia management are many.  While I have discussed the uselessness of kayexalate in my introductory post, I was thinking about discussing ECG changes and the “textbook progression” so often cited with peaked […]

Evidence Based Management of Acute Heart Failure: Forget LMNOP, think POND!


Case: Imagine you are an attending ED physician supervising a learner. A 72 year old female presents to the ED with cough and shortness of breath worsening over a week.  She has a history of Afib, previous MI, diabetes and dyslipidemia.  She has recently been non-compliant with her meds and has been taking some ketorolac […]

Thiamine Before Glucose will not cause Wernicke’s Encephalopathy

If there’s one area of medicine that suffers from more dogma than any other, it’s toxicology.   I’m not razzing tox, I love tox.  But management in toxicology usually = throw kitchen sink at patient, followed by a case report that concludes the last intervention done just prior to the patient improving is a new treatment […]

Drinking the PPI Hate-O-Rade

Hi all, sorry about the extended hiatus.  I was away after Christmas for about 12 days and have been getting back in the swing of things over the past week.  Since the break, one great new blog that has popped up on the FOAMed landscape is the boringem blog, started by Brent Thoma, one of […]

Evidence Based Laceration Repair

First, a huge thanks to everyone who has been visiting the site, tweeting and spreading the #FOAMed love.  FOAM is all about word of mouth, and having others spread the word drives me to put up more posts.  Second, if you have comments or suggestions to improve the blog, questions for me, or myths you’d […]

All about chest tubes

Of all the interventions we perform, chest tube insertion is one of the most dangerous, complicated and misunderstood.  Today I’ll discuss not only the myths, but also some unfortunate realities that we must understand when we undertake this procedure.Myth # 1Bigger is betterI’m pretty sure we’ve all been told, partially thanks to ATLS, that we […]

Why should we insert CVCs?

WHY SHOULD WE INSERT CVCs? CVCs/CVLs are found in many, if not all critically ill ICU patients.  Why? To monitor central venous pressure and fluid responsiveness?  To measure markers of perfusion?  To provide fluid resuscitation?Let’s discuss some common myths surrounding the uses of CVCs.A good place to start is a list of indications for insertion of central […]

Welcome to SOCMOB!

THE INTRO   “You’re not going to use lidocaine with epi for that ring block, are you?” “Whoa, that potassium is 7, go get some Kayexalate.” “Calcium in a digoxin overdose, you’ll kill them!” Do any of the above sound familiar to you?  I hope so! I’ll venture to guess that many of you have […]