ePulse: Highlights of the week 2 – 8 May 2020

ePulse: Highlights of the week 2 – 8 May 2020


It looks like the world is slowly returning to a somewhat normal state after COVID challenged not just medical systems but the integrity of evidence based medicine. In the world of FOAM, we rely on peer reviews to guide the posting of medical content and this has served us well.We look forward to the next few months and how colleagues will present the “evidence”.

The highlight of this week is algorithms and kudos to the WikEM Algorithm project for bringing these to life. All algorithms are now available on Ventricle and compliments the resources that we have already uploaded regarding these specific topics.

Keep calm and VENTRICLE on!



Check out the algorithms from the WikEM Algorithm Project. Search WikEM in the Author filter of engine and be guided by concise algorithms for common medical dilemmas.


COVID-19 Cardiovascular Literature Update


EM@3AM: Tibial Plateau Fracture

Really good overview of tibial plateau fractures.


EMRad: Can’t Miss Adult Shoulder Injuries

Emergency Medicine Cases

EM Quick Hits 18 Conservative Management Pneumothorax, Microdosing Buprenorphine, Practical Use of CRITOE, Canadian TIA Score, Pediatric Surviving Sepsis Guidelines, Safety of Peripheral Vasopressors


You gotta love algorithms!

In emergency medicine, the algorithm is the back bone for the way we triage, diagnose, manage and transfer our patients.

Algorithms are the roadmap that guides us in making better decisions for our patients. In combination with core skills taking a history, examination, using the bedside ultrasound and the interpretation of an array of special investigations, the algorithm is the essential glue that keeps the pieces floating around and helps us reaching our destination in a timely and safe manner.

The WikEM Algorithm project deserves some much needed kudos for developing and maintaining just shy of 50 algorithms, dedicated to emergency medicine. It is so good, that we had to integrate them all into our engine in less than 24 hours, while running a clinic and rounding in our local community hospital.

I personally can never remember the hyponatremia pathway. I have probably looked at this algorithm 100 times, but it never wants to stick, so needless to say, it was one of the first algorithms I uploaded in late 2019 from another source.

Early in my career the bradycardia, tachycardia, PEA and systole algorithms from ACLS were drilled into my tiny and then absorbent brain, by doing it and repeating it over and over again. These algorithms are based on core evidence from multiple randomized trials and initially made no sense to me, but I studied and memorized them and it provided me with a decent structure in running a code effectively, every time. It essentially created a sense of calm, when every neuron in my brain wanted to explode with doubt in situations that was literally life and death. The ACLS and PALS cards were carried around wherever I went and was often explored to confirm that I was in fact making the right decision at the right time.

The point of my rambling is that algorithms are designed and developed to provide structure. Use them, embrace them and let them guide you in times when it is hard to think.

You gotta love algorithms!

  • Disclaimer: The views expressed in this post is my own and related to my experiences within the Emergency Department.




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