October 12, 2026 – October 18, 2026
Weekly Roundup
16 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.
12 highlights · 9 featured sources
EM@3AM: Rectal Injuries
This emDOCs EM@3AM review covers traumatic rectal injuries, emphasizing that digital rectal examination has very low sensitivity for rectal injury (33%) and was associated with management changes in fewer than 4% of patients, so routine use is not recommended. For rectal foreign-body removal, flexible sigmoidoscopy—not repeat DRE or discharge—is the preferred next step when post-removal bleeding occurs in a stable patient.
TTL Tip 22: Graded Assertiveness
This emergency-medicine communication tip outlines two structured frameworks—PACE and CUSS—for raising safety concerns in the resus room, with language scaled to urgency. A key teaching point is that recipients of graded assertiveness (e.g., team leaders) must acknowledge and address challenges openly, as their response shapes whether colleagues will speak up in future.
Ep 300 - Decisions under pressure from Tactical Trauma
This St Emlyn's episode (ep. 300) compiles Tactical Trauma interviews exploring decision-making under pressure across four domains: Claire Park's 40–70 rule for acting with incomplete information at dangerous scenes; Sean Brayford-Harris's Ten Second Triage, deliberately stripped of physiology to suit non-clinical first responders; Alice Hutin's Paris prehospital eCPR service, where having the capability makes explaining non-candidacy harder; and Chris Bishop's multidisciplinary trauma-ECMO teleconference, developed partly because VA-ECMO anticoagulation conflicts with major bleeding.
Compartment Syndrome – 6 “Ps” or Only 1 “P” Matters?
A review article in the Journal of Trauma and Acute Care Surgery argues that pain out of proportion is the earliest and often only reliable physical exam finding in developing extremity compartment syndrome; the other classically taught "Ps" (pallor, pulselessness, paresthesia, paralysis, poikilothermia) indicate late or already-missed diagnosis.
#86 The Other Side of the Bed: Surviving the ICU and Beyond
This Critical Care Time episode features a patient, her caregiver-husband, and a physician who has experienced critical illness firsthand sharing perspectives on ICU survivorship, including delirium, caregiver burden, and the gap between survival and recovery; no clinical study is presented, but the discussion highlights how clinician communication and small acts of compassion shape patient experience.
Beyond Average: New Benchmarks for Excellence in Pediatric Emergency Care
Using a cross-sectional analysis of 5.3 million visits across 12 PECARN Registry EDs, Alpern et al. derived Achievable Benchmarks of Care from the highest-performing clinicians rather than site averages, yielding targets such as 97.8% corticosteroid use for asthma and 20-minute door-to-provider time. Sites skew toward dedicated pediatric centers, limiting generalizability to general EDs caring for most children.
The PEM Podcast: Pediatric Intubation: Getting the First Attempt Right with Dr. Josh Nagler
This PEM Podcast episode with airway educator Dr. Josh Nagler covers strategies to improve first-attempt intubation success in pediatric emergency settings, addressing preoxygenation, apneic oxygenation, video versus direct laryngoscopy, the NEAR4PEM pre-intubation checklist, and anticipating peri-intubation hypotension; no original study data are presented.
Toxicology: Iron
This PEM Currents episode reviews pediatric iron toxicity, emphasizing that early GI symptoms mimicking gastroenteritis and a deceptive latent-phase improvement can precede shock and metabolic acidosis. Key teaching points include drawing serum iron at 4–6 hours post-ingestion, noting that activated charcoal does not bind iron, and reserving IV deferoxamine for serious toxicity (shock, altered mental status, or iron level >500 µg/dL).
Normal saline is not normal and other nonsense that people love to spout (The PRoMPT trial)
The PRoMPT BOLUS trial, a multicenter open-label RCT of 8,482 children with septic shock, found no significant difference between balanced fluids and normal saline in the composite outcome of death, renal replacement therapy, or persistent kidney dysfunction (3.4% vs. 3.0%). A key limitation noted by the author is the lack of blinding despite identical-appearing fluids.
ECG Pointers: This ECG just went into M Mode
This ECG teaching case illustrates an inferior STEMI presenting with ventricular bigeminy, where PVCs superimposed on massive ST elevation produced an unusual "M"-shaped morphology. The case also reviews fibrinolytic therapy as a bridge when PCI is unavailable within 120 minutes, highlighting absolute contraindications and referencing the ASSENT-2 trial comparing tenecteplase to alteplase.
Do I Smell Relief – Alcohol Pad as Antiemetic?
An evidence review in EMJ found that inhaled isopropyl alcohol (IPA) is supported by current literature as an inexpensive and effective intervention for acute nausea in the ED, though the authors note its use in pregnant patients has not been studied, leaving a key population gap unaddressed.
emDOCs Podcast – Episode 150: Endophthalmitis
This emDOCs podcast episode covers endophthalmitis, a vision-threatening intraocular infection where early ophthalmology consultation and intravitreal antibiotics are the management mainstay. Key ED teaching points include that hypopyon and vitritis are suggestive but a normal retinal exam does not exclude the diagnosis, and systemic antibiotics alone are insufficient due to the blood-ocular barrier.
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.