July 20, 2026 – July 26, 2026
Weekly Roundup
514 resources from 8 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 · 7 featured sources
Intranasal Midazolam – Higher Dose Now, Less Later
In this single-center retrospective cohort study of 161 pediatric ED patients (≤22 kg), high-dose intranasal midazolam (0.5 mg/kg) was associated with lower rates of additional sedation or documented failure compared to low-dose (0.2 mg/kg), with no significant difference in adverse events or ED length of stay. Key limitations include disproportionate group sizes and small sample.
Tox Card: CHANTER Syndrome
emDocs reviews CHANTER syndrome, a rare pattern of cerebellar, hippocampal, and basal nuclei injury following drug overdose. It highlights persistent altered mental status, characteristic MRI findings, and the potential for treatable cerebral edema, explaining why recognition matters when imaging might otherwise suggest irreversible hypoxic injury.
PERC-Peds Rule Could Change How Children Are Evaluated for Pulmonary Embolism: A PECARN Study
The BEEPER study (PECARN, 21 EDs, n=3,988 children aged 4–17) prospectively evaluated the PERC-Peds rule for excluding PE without imaging. PERC-Peds achieved 99.6% sensitivity with one false negative; a sequential PERC-Peds–then–D-dimer strategy would have excluded PE in ~55% of enrolled children, though this observational study did not test implementation outcomes.
ECG criteria for left ventricular hypertrophy
LITFL compares major ECG criteria for left ventricular hypertrophy and explains why their performance varies across populations and reference standards. Most are specific but insensitive: a positive result supports an abnormal LV electrical pattern, while a negative ECG does not exclude anatomical hypertrophy.
#81 Awake Intubation
This podcast episode with Dr. Jarrod Mosier reframes awake intubation beyond anatomically difficult airways, arguing it is underused in physiologically dangerous airways (refractory hypoxemia, severe metabolic acidosis, RV failure), where RSI risks cardiovascular collapse. Key teaching points include early decision-making, thorough lidocaine topicalization (atomized, not nebulized), and that adequate topicalization reduces sedation requirements.
Cyclospora
This PEM Currents episode highlights that Cyclospora cayetanensis should be considered in children with prolonged, waxing-and-waning watery diarrhea in summer, especially when routine stool cultures and standard ova-and-parasite exams are negative—because many labs do not test for Cyclospora unless specifically ordered. TMP-SMX is the treatment of choice; no validated alternative exists for sulfonamide-allergic patients.
Naloxone for Out of Hospital Cardiac Arrest?
In this retrospective propensity-matched analysis of ~40,000 U.S. EMS encounters for OHCA, naloxone administration was associated with survival to hospital discharge (aOR 1.18, 95% CI 1.00–1.38) but not with ROSC (aOR 1.02). The association was stronger in PEA arrests; confounding by suspected overdose etiology remains a key limitation.
Journal Feed Wrap-Up
Three studies: the TOWAR RCT found no mortality benefit from prehospital low-titer group O whole blood versus component therapy in adult hemorrhagic shock transported by HEMS; a 2-year pediatric follow-up found organic causes in ~1 in 10 excessively crying infants, mostly cow's milk allergy; and the BIHCA randomized trial found sodium bicarbonate during in-hospital cardiac arrest did not improve ROSC, mortality, or neurologic outcome.
The Case of the Malignant Cohort
The Hydra trial found a YEARS-based strategy non-inferior to immediate CTPA in cancer patients with suspected PE, with 22% avoiding imaging. This commentary questions how well YEARS identifies genuinely low-risk patients with cancer and whether the higher D-dimer threshold can be applied reliably in that population.
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.