What would Weingart do in a small remote ED a thousand miles from an ICU? Find out here: broomedocs.com/2026/04/dr-s... #emimcc

There is something about sitting and listening to people speak at a conference that always leaves me thinking that absolutely everyone is a better clinician than I am

Great talk by Sarah Foohey on the sick neonate at the NYGH EMUpdate confirmed Key lesson - just use a resource to calm your nerve One of the best is by Dr Foohey herself: first10em.com/fooheysfigur...

Sucrose is not a pain medication A big mistake commonly made in pediatrics, based in good intentions, but with egregious results youtu.be/s6Ort-zU8lw

2 new RCTs looking at interventional approaches to pulmonary embolism Do you have access to these tools? Should you use them? #FOAMed

Yet again, treating numbers doesn't help This time, we have the first RCT looking at blood pressure targets in spinal cord injury

The first RCT looking at whole blood in trauma is out - and unsurprisingly, there is no benefit #FOAMed

Another collection of interesting emergency medicine articles #FOAMed

One point that isn't mentioned here but too often forgotten when noradrenaline seemingly isn't working: Are you actually using a representative blood pressure? Not so rare that a better (more central or better line) fixes the problem. Look at the whole patient, not just a number! #emimcc #cccsky

Dynamic left ventricular outflow tract obstruction A diagnosis I have certainly missed in my career - what about you? #FOAMed

Norepinephrine isn't work - now what?? A #FOAMed guide to the assessment and management of refractory shock

Don't get BiTEn by bispecific T-cell engagers This novel class of oncology drugs has 2 time sensitive, life threatening complications that emergency clinicians must know #FOAMed

Research Roundup – January 2026 The big paper of the month: ketamine vs etomidate for RSI Casey JD, Seitz KP, Driver BE, et al. Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2025 Dec 9. doi: 10.1056/NEJMoa2511420. Epub ahead of print. PMID: 41369227 On its…

Vernakalant: shockingly fast without the shock? There are many different approaches to stable patients with atrial fibrillation who present to the emergency department. Personally, I have leaned towards electrical cardioversion over chemical cardioversion in patients in whom cardioversion is…

Calciphylaxis In the Rapid Review series, I briefly review the key points of a clinical review paper (which often extends to multiple papers because I can’t help myself). The topic this time: Calciphylaxis The papers: Nigwekar SU, Thadhani R, Brandenburg VM. Calciphylaxis. N Engl J Med. 2018 May…

Has etomidate been killing people? Does ketamine cause cardiovascular collapse? Does the RSI trial settle these questions?? #FOAMed

Does coffee lead to atrial fibrillation | The DECAF trial You are at a conference. You had 1 glass of wine too many last night, so you had to add an extra coffee to get moving this morning. Then you feel a slight flutter in your chest. Caffeine is a stimulant, right? Could it be causing atrial…

Every day until Christmas, we're sharing a newly coined word from @drmattmorgan.bsky.social's medical lexicon Some are thoughtful. Some are quietly humorous. Today's word is Hospibrew: The distinctive hospital smell of equal parts reheated food and human waste www.bmj.com/content/391/...

The December 2025 FIrst10EM Research Roundup Get your #FOAMed #EBM fix with septic shock, bad data, contrast allergies, and even some rhinoceros pulmonary physiology

Under Trump, America is committing war crimes. But under Biden, there were irritating student protests at a college I did not attend. I have never felt more politically homeless.

The BroomeDocs First10EM JournalClub is out now on YouTube www.youtube.com/watch?v=tk3o... @broomedocs.bsky.social

Sweet’s Syndrome (aka acute febrile neutrophilic dermatosis) In the Rapid Review series, I briefly review the key points of a clinical review paper (which often extends to multiple papers because I can’t help myself). The topic this time: Sweet’s syndrome (aka acute febrile neutrophilic dermatosis)

When the parents in your kid's drama class strike up a conversation: "We don't do flu shots" "I found someone who will sell me homeopathic pellets" "When I took an extra Tylenol, I got liver pain, so I know this is safer" "Like, I don't know much about homeopathy, but it definitely works"

would not start antihypertensives. would discharge home immediately (it doesn’t seem like this admission is even indicated?) outpatient followup honestly this guy needs good outpatient management, not a fancy hospitalization that will be super expensive

I predict this will not be enough to convince some people: 285 studies 132 million people in real-world data 157,414 in randomized trials ~80% reduction in cervical cancer when given before age 16 No increase in serious adverse events @drjengunter.bsky.social www.eurekalert.org/news-release...

“I have been using a combination of cap refill and MAP since the original ANDROMEDA SHOCK paper” Justin explores the many limitations of this trial but then admits that he does use CRT as a resus target. I fundamentally agree. Implementing imperfect data into practice is complicated. #EMIMCC

Not so fast with the capillary refill guided resuscitation (ANDROMEDA-SHOCK-2) #FOAMed

💯💯 From my viewpoint in critical care the primary risk of the steroid protocol is (as I think you stated) diagnostic delays Every year we see several people who are seriously harmed by diagnostic failures 2/2 irrational fears of CT scans If you're critically ill we really need to know why, ASAP

Contrast may cause anaphylacTOID reactions (not anaphyLAXIS) (anaphylactoid rxns = angry mast cells spit out histamine; usually less severe than anaphylaxis) Canadian guidelines: don't pre-treatment w/ steroid, give antihistamine This makes physiological sense! Thank you science! #1/3. #EMIMCC

Stop using steroids to pretreat CT contrast allergy youtube.com/watch?v=h2Hv...

Stop using steroids to pretreat contrast allergy! The CAR/CSACI Practice Guidance for Contrast Media Hypersensitivity #FOAMed

Research Roundup (October 2025) There are, I think, some very interesting papers this time around. Physicians vs AI: ECG edition Shroyer S, Mehta S, Thukral N, Smiley K, Mercaldo N, Meyers HP, Smith SW. Accuracy of cath lab activation decisions for STEMI-equivalent and mimic ECGs: Physicians vs.…

Less is more when it comes to antibiotics. If you are still counselling your patients to take their full course, stop.

Amyloid-related imaging abnormalities: an emergency medicine nightmare? If you had asked me 5 years ago whether a disease modifying agent for Alzheimer’s disease would be developed, I would have laughed. “Moonshot; million to one; when pigs can fly”. Seems like I am as good at predicting the…

The First10EM Research Roundup for September 2025 It has been a while since I have critically appraised. Life without medical journals is sort of nice, but I guess it just isn’t me, so I am back and nerdier than ever. That means there are some strange selections this time around, but there are…

The continuing quest to treat numbers, not patients (OPTRESS) #FOAMed

In a beautiful park, by the ocean, on a sunny day, with my boy Remember why you do what you do

The First10EM wrap-up: Updates on the website, interesting media, good FOAMed, and random thoughts

If interested in ketamine for status, great debate emcrit.org/emcrit/ketam... @first10em.bsky.social vs @emcrit.bsky.social #EMIMCC

Noah Wiley on an episode of the the SGEM?? Absolutely crazy episode of FOAMed pca.st/episode/2558...

New World Screwworm It is fascinating. It is disgusting. It is on the rise, and so although we would all probably prefer not to see this, it is something we need to know #FOAMed

This... is disturbing. Thanks for sharing this education... I think.

New World Screwworm It is fascinating. It is disgusting. It is on the rise, and so although we would all probably prefer not to see this, it is something we need to know #FOAMed

The PECARN c-spine rule will cause a lot of harm (if anyone is silly enough to use it)

Is “First do no harm” a “deepity”?

For us it’s about exactly the elements in your last paper - recognising that sometimes the situation doesn’t fit the protocol or policy. The reporting provides an opportunity to ascertain whether the policy needs to change.

Nice! It might interest you to know that NSW ambulance has pathways for reporting and analysing “variance to practice”, another thing I think many hospitals could learn from.

My latest for @thestar.com, on the national crisis that doesn't seem to a part of the election. www.thestar.com/opinion/cont...

Thyroid storm diagnosis 1) TSH results can be delayed + not always available 2) Burch-Wartofsky scale: bedside clinical scoring system that requires no testing 3) High suspicion = immediate management youtube.com/shorts/E_U_V... #EMIMCC #MedSky

'Can you send me your "presentation"?' No. My slides are visual aids within my presentation. If your slides are so text-heavy that they contain all the information, you didn't do a presentation but a narrated collective document reading. Also, no you can't have my visual aids. Make your own.