Articles of the month (November 2016)

It’s that time again. Sure, there may be a lot to do during the month of December, but what better way to procrastinate than to grab a mug of hot chocolate, sit down in front of the fire, and read about some evidence based medicine….

(If that doesn’t sound appealing, you could toss in some earphones while you do your holiday shopping and listen to me and Casey ramble about these papers in the audio version on the BroomeDocs podcast.) Continue reading “Articles of the month (November 2016)”

Thyroid storm

The emergency department management of severe, decompensated hyperthyroidism


A 45 year old woman with a past medical history of hyperthyroidism is brought into the emergency department by her partner. She has had urinary tract symptoms for the last 2 days, but now she looks really sick. She has been having diarrhea and crampy abdominal pain. She is having a hard time concentrating, is tremulous, and drenched in sweat. Her vital signs at triage include an irregular heart rate of 142 and a temperature of 39.5 degrees celsius. Continue reading “Thyroid storm”

Finding impactful images (for free)

I am really excited to be attending The Teaching Course in New York City starting today. In the spirit of that course, I thought I would include a quick post on the best websites I know of to get free, high quality, impactful images to use in educational materials. A few well chosen, relevant images can drastically transform the content you create. I use these sources almost every day, trying to improve the look of First10EM and the presentations I give. I think it is essential to be mindful of copy-right, which is why these resources are generally better than just performing a google image search. If you know of any other sources for free, high quality images, please share them below. Continue reading “Finding impactful images (for free)”

Lecture handout: Social Media in Medicine (University of Toronto Anesthesia and Surgery Faculty Development Day)

This handout accompanies the social media in medicine seminar as part of the University of Toronto Anesthesia and Surgery Faculty Development Day. It is primarily a collection of links to good resources explaining FOAM and how you can get involved in this fantastic online medical community.

What is FOAM?

This is how Salim Rezaie of REBEL EM explains FOAM:

FOAMed quite simply stands for Free Open Access Medical Education

It might be easier to get a couple of misnomers out of the way right off the bat:

  • FOAM IS NOT Social Media (Twitter, FaceBook, Google+, etc…)
  • FOAM IS NOT a Teaching Philosophy
  • FOAM IS independent of platform or media (Blogs, Podcasts, Videocasts, etc…)
  • FOAM IS an interactive collaboration of like minded individuals, free of geographic hindrances and time zones, with one single goal…to make the world of medicine better.

Quite simply, FOAM is the concept, #FOAMed is the conversation

Here are a few resources that further explain this FOAM concept:

What is FOAM? On the original FOAM site Life in the Fastlane

And of course, watching Mike Cadogan (the creator of the term “FOAM”) is essential. This is a video from ICEM 2012, but unfortunately the quality is not great:

Consuming FOAM

Salim’s “Got FOAM” post will cover basically everything you want to know about how and why to access free open access medical education resources.

EMCrit has an excellent review of FOAM in the post The online hierarchy of needs – social media and FOAM

StEmlyns has a great post entitled How to integrate #FOAMed into #MedEd

Andy Neil also has an excellent guide to consuming FOAM on Emergency Medicine Ireland

If you prefer a more traditional guide to using FOAM, there is a publication by Brent Thoma in the Annals of Emergency medicine (that is thankfully free, open-access) that covers how to effectively use online resources in emergency medicine. (I think these lessons apply to other specialities as well). The strategies are:

  1. Use a RSS (really simple syndication) reader
  2. Use a podcast application
  3. Use compilations to find quality resources
  4. Use social networks to connect with content producers and peers
  5. Use custom search engines to find resources when they are needed

Blogs (RSS reader)

Feedly_Logo.pngYou will want something to collect new blog posts for you, so you don’t have to check all the blogs you follow manually. This is called a news aggregator or a RSS reader. My personal choice is Feedly, but there are many options out there.
Another essential service is Pocket. There are a lot of new blog posts but only so much time. When you see something that looks interesting, but don’t have time to read it right away, saving it to Pocket is a good idea. This way you can collect interesting pieces for when you have free time, and they are also available offline, which is really helpful when you are stuck on an airplane.


You will also want something to automatically download new podcasts (as well as play them). You can use iTunes, or any of a numbers of other options. Personally, I use Downcast, because it had the best features when I chose it a few years ago, but it does cost a small amount of money, and other options are free.

Joining the conversation

Twitter300.pngOnce you have started to consume the FOAM resources out there, you are bound to have something you want to say. Probably the best way to get involved in the conversation is by getting yourself a Twitter account and replying to the content creators. You can also join the discussion by leaving comments on the bottom of blog posts, or joining specific google plus or Reddit communities.

Here are a series of videos from Rob Rogers (of the Teaching Institute) that go over how to use twitter

Producing FOAM

As you become more comfortable with blogs and podcasts, you might find yourself wanting to join the conversation. After all, you are probably already creating high quality educational material for rounds or other teaching sessions. Why not share it with the world? Here are some guides that can help you with that process:

Andy Neil’s blog post on producing FOAM covers everything from recording podcasts, recording screen-casts, creating a blog, using google plus, to creating videos

How to start a medical podcast on EMCrit

Some related (old-school) publications about FOAM

Nickson CP et al. Free Open Access Medical education (FOAM) for the Emergency Physician. Emergency Medicine Australasia (2014) 26, 76–83. (PDF)

Cadogan M et al. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002–2013). Emerg Med J 2014; 31(e1):e76-7 (PDF)

Mallin M et al. A Survey of the Current Utilization of Asynchronous Education Among Emergency Medicine Residents in the United States. Acad Med. 2014 Apr;89(4):598-601. PMID: 24556776

Scott KR, et al. Integration of Social Media in Emergency Medicine Residency Curriculum. Ann Emerg Med 2014 DOI 10.1016/j.annemergmed.2014.05.030

Kind T, et al. Twelve tips for using social media as a medical educator. Medical Teacher 2014; 36: 284

Articles of the month (October 2016)

The end of another month can only mean one thing: I have once again read too many articles, and I feel the need to share them all with you. I think there is an excellent spectrum of really interesting papers this month, and as always I discuss them at length with Casey Parker on the Broome Docs podcast. Continue reading “Articles of the month (October 2016)”

Communicating diagnostic uncertainty

My transition from medical student to practicing diagnostician was marked by one key realization: doctors don’t make definitive diagnoses. Many think that we do. Our patients are certainly under that illusion. But even at the best of times, the physician’s job to to determine the probability of disease. Continue reading “Communicating diagnostic uncertainty”

Resuscitation of the crashing infant

An approach the the initial resuscitation of the critically ill child


It is your last of 3 night shifts, but so far it has been great. You successfully resuscitated a woman with severe postpartum hemorrhage. You got ROSC on a young cardiac arrest patient, and just heard that he is awake and talking after having his LAD opened in the cath lab. You even managed to get the Cunningham technique to work on a dislocated shoulder for the first time in your career. Now, during a lull, you are joking with the nurses, and someone says the work “quiet”. The next minute, the triage nurses is running down the hallway with a limp, blue 3 week infant in her arms and 2 very scared parents in tow…

Continue reading “Resuscitation of the crashing infant”