September 14, 2026 – September 20, 2026
Weekly Roundup
21 resources from 7 sources were added to the FOAM Cortex library this week and are now indexed. Explore a selection below, with links to the original educators.
9 highlights · 5 featured sources
EM@3AM: Agitation in the Elderly
This emDOCs EM@3AM review covers evaluation and management of agitation in elderly ED patients, emphasizing that agitation should be treated as delirium until proven otherwise and that reversible medical causes must be identified before pharmacologic sedation. Non-pharmacologic measures are first-line; if medications are needed, second-generation antipsychotics (e.g., olanzapine 2.5–5 mg) are preferred over first-generation agents or benzodiazepines, which may worsen delirium in older patients.
Ep 297 - The 5th Universal Definition of MI - what emergency clinicians need to know
This St Emlyn's episode features Prof. Rick Body summarising the Fifth Universal Definition of MI, which replaces the numbered type system with primary, secondary, and procedure-related categories, formally endorses sex-specific troponin thresholds, and now requires imaging to confirm (rather than merely suggest) MI—leaving troponin rise plus symptoms as only a "likely" diagnosis without it. Delta interpretation and chronic myocardial injury criteria also carry important nuances for ED practice.
Does a Pelvic Binder Reduce Transfusions?
In this nationwide propensity-matched cohort study of pelvic fracture patients, prehospital pelvic binder use was not associated with decreased transfusion requirements but was associated with increased angioembolization rates. The authors note limitations that may reduce real-world applicability of these findings.
Decoding DIC
The 2025 ISTH consensus update reframes DIC as a dynamic, etiology-dependent continuum rather than a binary diagnosis, explicitly incorporating endothelial injury and formalizing a phase model from pre-DIC to overt disease. The article argues the ED is a critical window for earlier recognition using the SIC score in sepsis and updated ISTH overt DIC score, though the hypothesis that earlier scoring improves outcomes remains consensus-based rather than RCT-proven.
#83 B2B Pulse Oximetry
This Critical Care Time episode covers pulse oximetry limitations, including a 15–30 second circulatory lag, perfusion-dependence, and inability to detect abnormal hemoglobins. A key teaching point is that standard two-wavelength devices systematically overestimate SpO₂ by up to ~3% in darker-skinned patients, and that evidence from multiple trials supports targeting SpO₂ 92–96% rather than 100%, since hyperoxia carries signals of harm.
ToxCard: Arsenic Toxicity
This ToxCard reviews acute arsenic toxicity, highlighting that severe presentations include "rice water" diarrhea, refractory hypotension, QT prolongation, and lactic acidosis. Early IM dimercaprol (BAL) chelation is emphasized, with one case series finding 75% survival when initiated within 6 hours versus 45% when delayed beyond 9 hours; oral succimer is an alternative for more stable patients.
Ahhhh-Choo! AAP 2026-27 Guidance on Pediatric Influenza
The source content is truncated and contains only a brief teaser without substantive findings, recommendations, or teaching points from the AAP policy statement itself.
#84 Acid-Base w/ Dr Sara Crager
This Critical Care Time episode features Dr. Sara Crager presenting a bedside "State → Process → Story" framework for acid–base interpretation, emphasizing that a normal pH does not exclude major disorders, that PaCO₂ must be interpreted relative to HCO₃⁻, and that bicarbonate reflects a vector sum of simultaneous metabolic processes—with albumin correction and strong ion difference (Na−Cl) helping unmask hidden anion-gap acidoses or metabolic alkalosis.
emDOCs Podcast – Episode 148: Multiple Myeloma Part 2
This emDOCs podcast episode covers emergency complications of multiple myeloma beyond the initial presentation, focusing on infection (7- to 11-fold higher risk than the general population, with pneumonia the most common bacterial cause), musculoskeletal injury (osteolytic disease in 70%, 9-fold fracture risk), neurologic emergencies (spinal cord compression most severe), and cardiac, thrombotic, and endocrine complications including VTE and treatment-related adrenal insufficiency.
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.