August 31, 2026 – September 6, 2026
Weekly Roundup
24 resources from 9 sources were added to the FOAM Cortex library this week and are now indexed. Explore a selection below, with links to the original educators.
10 highlights · 7 featured sources
EM@3AM: Aplastic Anemia
This emDOCs EM@3AM review covers aplastic anemia in the ED, emphasizing that diagnosis requires pancytopenia with reticulocytopenia—reflecting marrow failure rather than peripheral destruction—and that hypocellular bone marrow confirmed by biopsy is the definitive finding. ED priorities include irradiated transfusions, neutropenic fever workup, and urgent hematology consultation, particularly when thrombotic thrombocytopenic purpura cannot be excluded.
Pulmonary Embolism in Children: BEEPER Study
The BEEPER study (Lancet Respir Med, 2026) prospectively validated the PERC-Peds rule across 21 US pediatric EDs in 3,988 children aged 4–17 evaluated for PE, finding 99.6% sensitivity and a 0.1% false-negative rate; a sequential PERC-Peds–then–D-dimer strategy was estimated to reduce CT use by ~20%, though the observational design and primarily academic sites limit generalizability.
CPR + Hand Placement – Can We Do Better?
This study used ultrasound to evaluate ideal hand placement for chest compressions, suggesting current AHA guidelines may not target the optimal compression point. The full findings are paywalled, but the takeaway is that evidence-based refinement of CPR hand placement remains an open question.
Rapid Rounds with HBD: Chest Pain
This HipPEMcrates teaching case uses a 17-year-old with exertional chest pain, tachycardia, and recent viral illness to illustrate a structured approach to pediatric chest pain, culminating in a pericarditis diagnosis on EKG. The article emphasizes red-flag history features, a stepwise pediatric EKG method, and the role of cardiac POCUS, while noting that most pediatric chest pain is benign.
From Triad to Diamond: Calcium in Prehospital Trauma Resuscitation
This NAEMSP article argues that hypocalcemia should expand the "Lethal Triad" to a "Lethal Diamond," noting that studies found hypocalcemia in 54–64% of trauma patients even without blood-product administration. A 2026 retrospective study (Rajesh et al.) found calcium chloride ≥1 g per 2 units of whole blood was associated with reduced 24-hour mortality, though the ongoing CAVALIER randomized trial has not yet reported outcomes.
ASPIRED: Ambulatory ECG Monitoring After Unexplained Syncope
The ASPIRED RCT (2,234 adults, 45 UK hospitals) found that a 14-day ambulatory ECG patch fitted within 72 hours of unexplained syncope did not reduce patient-reported syncopal episodes at one year (primary outcome negative; IRR 0.89, p=0.42), but was associated with more than double the detection of clinically significant arrhythmias (22% vs. 9%) and more targeted treatment; a mortality signal (OR 0.50) was a secondary, unadjusted finding requiring further study.
The Case of the Arbitrary Boundary
A new meta-analysis (Liu et al.) found balanced crystalloids significantly reduced sepsis mortality (RR 0.92, p=0.01), but this post contrasts it with the BEST-Living individual-patient-data meta-analysis, whose credible interval crossed 1. The difference stems largely from modeling assumptions—fixed-effect vs. Bayesian hierarchical—rather than meaningfully different data, illustrating that the p=0.05 threshold is an arbitrary boundary, not a clinical verdict.
emDOCs Podcast – Episode 147: Multiple Myeloma Part 1
This emDOCs podcast episode reviews multiple myeloma (MM) as an emergency diagnosis, noting that the ED is the most common route to initial diagnosis. It covers hematologic complications (anemia in 73% at diagnosis, rare hyperviscosity), renal injury (present in ~50%), and hypercalcemia (15–28%), with management stratified by severity and renal function.
Discharging Low-Risk PE Patients is Safe
This single-center Canadian retrospective study examined outpatient management of pulmonary embolism diagnosed in the ED, finding that discharge of select low-risk patients was associated with safe outcomes. The retrospective design and single-center setting limit generalizability, and full details of the patient selection criteria are not available in the supplied content.
HipPEMcrates FOAM Roundup | August 2026
This August 2026 HipPEMcrates roundup curates 26 PEM FOAM resources across 10 blogs and 12 podcasts, covering the prematurely halted PECARN STArT trial (IV arginine did not shorten sickle cell pain crises), the BEEPER/PERC-Peds rule for pediatric PE, PRoMPT BOLUS trial findings on fluid selection in septic shock, and practical topics including dextromethorphan overdose, embedded earrings, toddler's fractures, and human factors in clinical reasoning.
New to the library does not necessarily mean newly published. This roundup features public resources added during the week and successfully indexed by the time the issue was prepared. Follow the links to read or listen at the original source.